Melatonin status in pediatric intensive care patients with sepsis*

Abstract

The present study shows that, in contradiction to results in adult patients, the nocturnal melatonin concentrations are not decreased in septic pediatric intensive care unit patients despite severe disease. Further investigations are needed to identify whether treatment with melatonin may have beneficial effects in pediatric intensive care unit patients with sepsis/septic shock.

Serum melatonin levels are associated with mortality in severe septic patients

“…In one study of 14 septic patients was found a negative correlation between Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and serum melatonin levels [28]. On the other hand, in one study with 20 septic pediatric patients were found higher serum melatonin concentrations in septic patients than in controls, and in non-survivors than in survivor septic patients [27], although the sample size was too small to demonstrate that serum melatonin levels are associated with mortality. Thus, the findings of the previous small studies appear contradictory.…”

“…However, melatonin in septic patients has been scarcely explored and only in studies of small sample size (maximum 20 patients) [24][25][26][27][28][29][30]. In one study of 14 septic patients was found a negative correlation between Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and serum melatonin levels [28].…”

New Prognostic Biomarkers of Mitochondrial Oxidative Stress in Septic Patients

“…In a study on 14 septic patients, there was a negative correlation between the APACHE-II scores and serum melatonin levels (48). In contrast, in another study on 20 septic pediatric patients, serum melatonin concentrations were higher in septic patients than in controls, and in non-surviving septic patients than in surviving ones (47).…”

“…However, melatonin in septic patients has been scarcely explored only in studies with small sample sizes (maximum 20 patients) and the findings appear contradictory (44)(45)(46)(47)(48)(49)(50). In a study on 14 septic patients, there was a negative correlation between the APACHE-II scores and serum melatonin levels (48).…”

Multiple Facets of Melatonin in Immunity: Clinical Applications

“…In a similar study, nocturnal melatonin concentrations of children with sepsis in a septic shock state were signifi cantly higher than those of septic patients without septic shock state. The 24-h aMT6 excretion in septic patients with liver dysfunction was found significantly lower than in septic patients without liver dysfunction [ 116 ]. Therefore, the parallel measurement of serum melatonin together with the urine levels of aMT6 would be very convenient data to discard aMT6 disturbances due to hepatic dysfunction.…”