Paediatric logistic organ dysfunction (PELOD) score

Leteurtre, Stéphane; Duhamel, Alain; Grandbastien, Bruno; Lacroix, Jacques; Leclerc, Francis

doi:10.1016/s0140-6736(06)68371-2

Cited by 95 publications

(93 citation statements)

References 5 publications

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“…Clearly, mortality should not be considered as the only end point and thus should be studied together with other factors or scores examining patient survival. There are several scoring systems for estimating pediatric organ dysfunction and children's mortality, for example the Pediatric Logistic Organ Dysfunction (PELOD) score (44,45), the Multiple Organ System Failure (MOSF) score (46), or the Pediatric Risk of Mortality (PRISM) score (47). The PRISM score, a physiology-based measurement, is the most common currently available system used for mortality prediction in the PICU.…”

Section: Discussionmentioning

confidence: 99%

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Mickiewicz

Vogel²,

Wong³

et al. 2013

Am J Respir Crit Care Med

167

175

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Rationale: Septic shock is a significant cause of morbidity and mortality in the pediatric population. Early recognition of septic shock and appropriate treatment increase survival rate; thus, developing new diagnostic tools may improve patients' outcomes. Objectives: To determine whether a metabolomics approach could be useful in the diagnosis and prognosis of septic shock in pediatric intensive care unit (PICUs). Methods: Serum samples were collected from 60 patients with septic shock, 40 PICU patients with systemic inflammatory response syndrome (not suspected of having an infection), and 40 healthy children. Proton nuclear magnetic resonance spectroscopy spectra were analyzed and quantified using targeted profiling methodology. Measurements and Main Results: Multivariate statistical analysis was applied to detect specific patterns in metabolic profiles and to highlight differences between patient samples. Supervised analysis afforded good predictive models and managed to separate patient populations. Some of the metabolite concentrations identified in serum samples changed markedly, indicating their influence on the separation between patient groups. These metabolites represent a composite biopattern of the pediatric metabolic response to septic shock and might be considered as the basis for a biomarker panel for the diagnosis of septic shock and its mortality in PICU. Conclusions: Our results indicate that nuclear magnetic resonance metabolite profiling might serve as a promising approach for the diagnosis and prediction of mortality in septic shock in a pediatric population and that quantitative metabolomics methods can be applied in the clinical evaluations of pediatric septic shock.Keywords: pediatric septic shock; biomarkers; metabolomics; proton nuclear magnetic resonance spectroscopy; mortalityIn the 1980s the death rate from septic shock in children was around 50% (1, 2), but over the past few decades with better early diagnosis and therapy it has decreased to approximately 10% (3, 4). Unfortunately, in third world countries the mortality rate is still extremely high (5, 6). Moreover, every hour of septic shock without appropriate resuscitation and restoration of blood pressure increases mortality risk by 40% (7). Septic shock is a very dynamic process, and the clinical status of a child can deteriorate quickly (8). The first hours after the diagnosis are called the "golden hours" for a patient's survival; therefore, aggressive and goal-directed treatment should be initiated as quickly as possible (9). It is reported that those children in whom septic shock is recognized early and properly treated have a much higher survival rate than children who were diagnosed later (10-12). Thus, developing diagnostic approaches that might accelerate disease recognition is extremely important to improve patient outcomes and decrease mortality.In this study we investigated whether we could use a metabolomics approach for the diagnosis and prognosis of pediatric septic shock. Metabolomics is defined as "the quantita...

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Section: Discussionmentioning

confidence: 99%

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Mickiewicz

Vogel²,

Wong³

et al. 2013

Am J Respir Crit Care Med

167

175

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“…There were no exclusion criteria. The data, collected in a de-identified manner, included primary and secondary admission diagnosis, use of mechanical ventilation, vasoactive or neuromuscular drugs, vital signs, age, height, weight, body mass index (BMI), Pediatric Risk of Mortality Score (PRISM), 12 Pediatric Logic Organ Dysfunction Score (PELOD), 13,14 nutrition support, and length of ICU and hospital stay. Underweight, overweight, and obesity were defined as <5th, 85th-95th, and >95th percentile based on Centers for Disease Control and Prevention (CDC) weight for height growth chart for children age <2 years and BMI chart for children age >2 years.…”

Section: Methodsmentioning

confidence: 99%

Is Indirect Calorimetry a Necessity or a Luxury in the Pediatric Intensive Care Unit?

Kyle

Arriaza

Esposito

et al. 2011

J Parenter Enteral Nutr

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Critically ill children in the pediatric intensive care unit (PICU) differ in their energy needs from healthy children in terms of underlying metabolism and growth, comorbidities, and preexisting energy reserve, and this makes it difficult to estimate energy needs in these patients. Estimates of energy expenditure using available standard equations are often unreliable. True energy needs can be determined only by measuring energy expenditure with indirect calorimetry (IC). This preliminary study determined how many PICU patients would be candidates for IC, based on current recommendations by the American Society for Parenteral and Enteral Nutrition. IntroductionCritically ill children, especially infants, in the pediatric intensive care unit (PICU) are at high risk of developing nutrition deficiencies, altered nutrition status, and anthropometric changes that may lead to increased morbidity.1,2 Acute injury, inflammation, surgery, or sepsis markedly alters energy needs by inducing hyper-and hypometabolic conditions 3-5 that may be present in a single patient at different time points in the continuum of care. It is essential to provide the appropriate energy, substrate distribution, and micronutrients necessary to support the ongoing metabolic and stress response to avoid the loss of critical lean body mass and worsening of any existing nutrient deficiencies. AbstractBackground: Critically ill children differ in their energy needs from healthy children in terms of underlying metabolic derangement, comorbidities, energy reserve, and response to illness. This study determined how many pediatric intensive care unit (PICU) patients were candidates for indirect calorimetry (IC), per American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recommendations. Methods: Admission diagnosis, demographics, type/amount of nutrition support, length of intensive care unit/hospital stay were collected. Patients were classified as candidates for IC per A.S.P.E.N. guidelines. Results: Mean (SD) age of patients (n = 150) was 6.7 (5.6) years, with PICU length of stay of 3.9 (5.3) days. IC was indicated in 72.0% (108/150) of patients during PICU days 1-7. Patients with miscellaneous (50%), neurological (73%), respiratory (81%), sepsis (83%), and oncology (100%) diagnoses were candidates for IC. Underweight/overweight/obese (32.4%), hypermetabolism (26.4%), and not meeting nutrition goals (13.7%) were the most frequent indications for IC (χ

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“…The pediatric logistic organ dysfunction (PELOD) score is a prospectively validated outcomes measure of the degree of multiple organ dysfunction in pediatric patients [42][43][44][45][46][47] . The PELOD score was calculated daily from 12 variables derived from 6 organ system categories: neurological, cardiovascular, renal, respiratory, hematological, and hepatic.…”

Section: Organ Dysfunction-pelod Scorementioning

confidence: 99%

Autologous Bone Marrow Mononuclear Cells Reduce Therapeutic Intensity for Severe Traumatic Brain Injury in Children

Liao

Hetz²,

Shah³

et al. 2014

Journal of the American College of Surgeons

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Paediatric logistic organ dysfunction (PELOD) score

Cited by 95 publications

References 5 publications

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Is Indirect Calorimetry a Necessity or a Luxury in the Pediatric Intensive Care Unit?

Autologous Bone Marrow Mononuclear Cells Reduce Therapeutic Intensity for Severe Traumatic Brain Injury in Children

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