scholarly journals 507: ASSOCIATION OF ILLNESS SEVERITY WITH FAMILY OUTCOMES FOLLOWING PEDIATRIC SEPTIC SHOCK

2021 ◽  
Vol 50 (1) ◽  
pp. 245-245
Author(s):  
Elizabeth Killien ◽  
Jerry Zimmerman ◽  
J. Lin Di Gennaro ◽  
R Watson
Keyword(s):  
Septic Shock ◽  
Illness Severity ◽  
Family Outcomes

Random serum free cortisol and total cortisol measurements in pediatric septic shock

2018 ◽  
Vol 31 (7) ◽  
pp. 757-762
Author(s):  
Kusum Menon ◽  
Dayre McNally ◽  
Anand Acharya ◽  
Katharine O’Hearn ◽  
Karen Choong ◽  
...  
Keyword(s):  
Septic Shock ◽  
Controlled Trial ◽  
Illness Severity ◽  
Strongly Correlated ◽  
Eligibility Criteria ◽  
Prism Score ◽  
Total Cortisol ◽  
Free Cortisol ◽  
The Relationship ◽  
Strong Agreement

Abstract Background The aim of the study was to examine the relationship between serum total cortisol (TC) and free cortisol (FC) levels in children with septic shock and the relationship of these levels with baseline illness severity. Methods A sub-study of a randomized controlled trial (RCT) of hydrocortisone vs. placebo in pediatric septic shock conducted in seven academic pediatric intensive care units (PICUs) in Canada on children aged newborn to 17 years. Thirty children with septic shock had serum sent for TC and FC measurement within 6 h of meeting the study eligibility criteria. Results Baseline FC and TC levels were strongly correlated with baseline Pediatric Risk of Mortality (PRISM) score (R2=0.759, p<0.001; R2=0.717, p<0.001) and moderately correlated with admission Vasotropic Inotropic Score (VIS) (R2=0.489, p<0.001; R2=0.316, p<0.001). Serum TC levels were highly correlated with FC levels (R2=0.92, p<0.001) and showed strong agreement (R2=0.98, p<0.001 on a Bland-Altman plot). The ratio of FC to TC moderately correlated with TC levels (R2=0.46, p<0.001) but did not correlate with baseline albumin levels (R2=0.19, p=0.13). Conclusions Random TC and FC levels are strongly correlated, show strong agreement and are reflective of illness severity in children with septic shock. As such, isolated FC measurement does not appear to provide added information relative to TC in acutely ill children with septic shock.

scholarly journals Evaluating the Role of the Interleukin-23/17 Axis in Critically Ill COVID-19 Patients

2021 ◽  
Vol 11 (9) ◽  
pp. 891
Author(s):  
Edison Jahaj ◽  
Alice G. Vassiliou ◽  
Chrysi Keskinidou ◽  
Parisis Gallos ◽  
Charikleia S. Vrettou ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Critical Illness ◽  
Critically Ill ◽  
Potential Role ◽  
Illness Severity ◽  
Icu Admission ◽  
Interleukin 23

Studies have hypothesized a potential role of the interleukin (IL)-23/17 axis in coronavirus disease 2019 (COVID-19). However, to date, levels of IL-23 and 17 have not been compared between critically ill COVID-19 patients and critically ill non-COVID-19 patients. IL-23 and 17 were measured on admission to the intensive care unit (ICU) in critically ill COVID-19 (N = 38) and critically ill non-COVID-19 (N = 34) patients with an equal critical illness severity. Critically ill non-COVID-19 patients did not have sepsis or septic shock on ICU admission. None of the enrolled patients had previously received corticosteroids. In our study, circulating IL-17 levels were higher in the COVID-19 patients. More specifically, critically ill COVID-19 patients had levels of 0.78 (0.05–1.8) pg/mL compared to 0.11 (0.05–0.9) pg/mL in the critically ill non-COVID-19 patients (p = 0.04). In contrast, IL-23 levels were comparable between groups. A group of patients hospitalized in the specialized COVID-19 clinic (N = 16) was also used to evaluate IL-17 and IL-23 levels with respect to COVID-19 severity. Non-critically ill COVID-19 patients had undetectable levels of both cytokines. Our results support the notion of inhibiting IL-17 in critical COVID-19 infection.

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