scholarly journals Apolipoprotein A-V Is a Novel Diagnostic and Prognostic Predictor in Pediatric Patients with Sepsis: A Prospective Pilot Study in PICU

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Chunxia Wang ◽  
Yun Cui ◽  
Huijie Miao ◽  
Xi Xiong ◽  
Jiaying Dou ◽  
...  
Keyword(s):  
Pilot Study ◽  
Pediatric Patients ◽  
Characteristic Curve ◽  
Kidney Injury ◽  
Healthy Children ◽  
Prognostic Predictor ◽  
Prospective Pilot Study ◽  
Serum Proteomics ◽  
Apolipoprotein A

Background. Sepsis induces the release of lipid mediators, which control both lipid metabolism and inflammation. However, the role of serum apolipoprotein A-V (ApoA5) in sepsis is poorly understood in pediatric patients. Methods. ApoA5 was screened from serum proteomics profile in lipopolysaccharide- (LPS-) treated mice for 2 h, 24 h, and controls. Then, we conducted a prospective pilot study, and patients with sepsis admitted to a pediatric intensive care unit (PICU) were enrolled from January 2018 to December 2018. Serum ApoA5 levels on PICU admission were determined using enzyme-linked immunosorbent assays (ELISA). Blood samples from 30 healthy children were used as control. The correlation of ApoA5 with the clinical and laboratory parameters was analyzed. Logistic regression analyses and receiver operating characteristic curve (ROC) analysis were used to investigate the potential role of serum ApoA5 as a prognostic predictor for PICU mortality in pediatric patients with sepsis. Results. A total of 101 patients with sepsis were enrolled in this study. The PICU mortality rate was 10.9% (11/101). Serum ApoA5 levels on PICU admission were significantly lower in nonsurvivors with sepsis compared with survivors (P=0.009). In subgroup analysis, serum levels of ApoA5 were significantly correlated with sepsis-associated multiple organ dysfunction syndrome (MODS) (P<0.001), shock (P=0.002), acute kidney injury (AKI) (P<0.001), acute liver injury (ALI) (P=0.002), and gastrointestinal (GI) dysfunction (P=0.012), but not respiratory failure, brain injury, and pathogenic species (all P>0.05). Correlation analyses revealed significant correlations of serum ApoA5 with Ca2+ concentration. Remarkably, the area under ROC curve (AUC) for serum ApoA5 levels on PICU admission was 0.789 for prediction of PICU mortality with a sensitivity of 75% and a specificity of 84.5% at a threshold value of 822 ng/mL. Conclusions. Serum ApoA5 level is associated with sepsis-associated shock, AKI, ALI, GI dysfunction, or MODS in children. Moreover, the findings of the present study suggest a prognostic value of ApoA5 in children with sepsis, and lower serum ApoA5 than 822 ng/mL predicts worse outcome in pediatric sepsis.

scholarly journals Are Tubular Injury Markers NGAL and KIM-1 Useful in Pediatric Neurogenic Bladder?

2021 ◽  
Vol 10 (11) ◽  
pp. 2353
Author(s):  
Joanna Bagińska ◽  
Agata Korzeniecka-Kozerska
Keyword(s):  
Neurogenic Bladder ◽  
Kidney Injury ◽  
Healthy Children ◽  
Tubular Injury ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Activity Assessment ◽  
Kidney Injury Molecule 1 ◽  
Tract Infections ◽  
Neutrophil Gelatinase

The lack of early biomarkers of renal damage in children with neurogenic bladder (NB) prompts us to investigate the role of promising proteins: neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1). This prospective analysis was conducted on 58 children with NB and 25 healthy children. We assessed urinary levels of NGAL and KIM-1 in both groups. Age, sex, anthropometric measurements, activity assessment, renal function, and urodynamics parameters were analyzed. The differences between the median uNGAL and uKIM-1 in the NB group compared to control were recorded. However, only uNGAL levels were statistically significantly higher. Statistically significant correlation was found between gender, recurrent urinary tract infections, bladder trabeculation, its compliance, activity assessment, and uNGAL. To conclude, elevated levels of uNGAL may be considered a biomarker of tubular injury in children with NB due to MMC in contrast to uKIM-1.

scholarly journals Evaluating the Role of Staphylococcus aureus Nasal PCR in Pediatric Head and Neck Infections

2021 ◽  
Vol 26 (7) ◽  
pp. 734-739
Author(s):  
Chandni Patel ◽  
Guru Bhoojhawon ◽  
Lukasz Weiner ◽  
Danelle Wilson ◽  
Derek Zhorne ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Treatment Failure ◽  
Head And Neck ◽  
Pediatric Patients ◽  
Total Duration ◽  
Kidney Injury ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Head And Neck Infections

OBJECTIVE Vancomycin is often empirically used in the management of head and neck infections (HNIs) in children. The objective of this study was to determine the utility of Staphylococcus aureus (SA) nasal PCR to facilitate de-escalation of vancomycin for pediatric HNIs. METHODS This was a single-center, retrospective cohort study of pediatric patients who received empiric intravenous vancomycin for a diagnosis of HNIs between January 2010 and December 2019. Subjects were excluded if they met any of the following: confirmed/suspected coinfection of another site, dialysis, immunocompromised status, admission to the NICU, alternative diagnosis that did not require antibiotics, or readmission for HNIs within 30 days of previous admission. The primary outcome was time to de-escalation of vancomycin. Total duration of antibiotics, treatment failure, hospital length of stay (LOS), and incidence of acute kidney injury (AKI) were also assessed. RESULTS Of the 575 patients identified, 124 patients received an SA nasal PCR. The median time to de-escalation was 39.5 hours in those patients compared with 53.7 hours in patients who did not have a SA nasal PCR (p = 0.002). No difference was noted in total duration of all methicillin-resistant Staphylococcus aureus antibiotics, hospital LOS, treatment failure, and AKI. CONCLUSIONS In a large cohort of pediatric patients with HNIs, those who underwent testing with an SA nasal PCR spent less time receiving intravenous vancomycin, although their LOS was not significantly reduced. Further investigation is needed to better define the role of SA nasal PCRs in determining antibiotic therapy for HNIs.

The role of nerve-preserving technique during total mesorectal excision. A prospective pilot study

2010 ◽  
Vol 36 (10) ◽  
pp. 1023
Author(s):  
V. Celentano ◽  
G. Luglio ◽  
G. Antonelli ◽  
R. Tarquini ◽  
B. Russo ◽  
...  
Keyword(s):  
Pilot Study ◽  
Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Prospective Pilot Study

Prospective Pilot Study of Mirabegron in Pediatric Patients with Overactive Bladder

2016 ◽  
Vol 70 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Anne-Sophie Blais ◽  
Geneviève Nadeau ◽  
Katherine Moore ◽  
Lucie Genois ◽  
Stéphane Bolduc
Keyword(s):  
Pilot Study ◽  
Overactive Bladder ◽  
Pediatric Patients ◽  
Prospective Pilot Study

scholarly journals Incidence and Causes of Infusion Alarms in a Neonatal and Pediatric Intensive Care Unit: A Prospective Pilot Study

2020 ◽  
Vol 25 (6) ◽  
pp. 500-506
Author(s):  
Caroline Fonzo-Christe ◽  
Nathalie Bochaton ◽  
Amalys Kiener ◽  
Peter C. Rimensberger ◽  
Pascal Bonnabry
Keyword(s):  
Pilot Study ◽  
Pediatric Patients ◽  
Pediatric Intensive Care ◽  
Occlusion Pressure ◽  
Drug Injection ◽  
Patient Factors ◽  
Related Factors ◽  
Infusion Pumps ◽  
Prospective Pilot Study ◽  
Event Logs

OBJECTIVES To evaluate the incidence and causes of infusion alarms in a NICU/PICU setting. METHODS We conducted a 90-day prospective analysis of event logs downloaded daily from infusion pumps (syringe and volumetric pumps). The details about conditions surrounding alarm events were described daily by bedside nurses on a standardized form. The occlusion pressure alarm was set at 300 mm Hg on each device. RESULTS Forty-one pediatric patients including 12 neonates, mean weight 11.0 ± 11.3 kg (minimum–maximum, 0.48–50), were included for a total infusion time of 2164 hours. Eight hundred forty-three infusion alarms were documented (220 [26.1%] occlusion; 273 [32.4%] infusion completed; 324 [38.4%] door open/syringe disengagement; 26 [3.1%] air-in-line) resulting in an incidence of 4.7 infusion (1.2 occlusion) alarms per patient per day. Detailed conditions surrounding occlusion alarm events were documented in only 22.7% (50/220) of the cases. Of these, 36% (18/50) were related to closed or clamped lines, 4% (2/50) to syringe change, 16% (8/50) to drug injection, and 8% (4/50) to patient-related factors. The remaining 36% (18/50) occurred without any apparent external cause during ongoing infusion, among these drug incompatibilities were a potential cause for 12 events. CONCLUSION Alarms from infusion pumps were frequent in the NICU/PICU setting, a quarter of them resulting from line occlusion. Other than well-known triggers (mechanical and patient factors), drug incompatibilities were identified as a potential cause for occlusion alarms in this pilot study.

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