Main Article Content
Background Sepsis remains a major cause of morbidity and mortality among critically ill children in the pediatric intensive care unit (PICU). Procalcitonin and lactate have been used as biomarkers of sepsis, as they have been correlated with disease severity, organ failure and death. The Pediatric Logistic Organ Dysfunction (PELOD) score is a tool to assess the severity of organ dysfunction in critically ill children. Objective To investigate the correlation between PELOD score and procalcitonin and lactate levels in pediatric sepsis. Methods A cross-sectional study was conducted in children with sepsis who were admitted to the PICU from April to July 2012. Sepsis was defined as systemic inflammatory response syndrome (SIRS), as a result of suspected or proven infection. Proven infection was defined as positive culture findings (blood, urine or other specimens) and/or serum procalcitonin >=2 ng/mL. Spearman’s test was used to assess for correlations between PELOD scores and procalcitonin as well as lactate levels. Results Thirty-two patients were analyzed, consisting of 18 males and 14 females with an age range of 1-432 months (median 21 months). There was no statistically significant correlation between procalcitonin level and PELOD score (r=- 0.186, 95%CI -0.502 to 0.174, P=0.308) nor between lactate level(r=-0.069, 95%CI -0.408 to 0.287, P=0.709) and PELOD score. Conclusion Serum procalcitonin and lactate levels are not correlated with PELOD scores in children with sepsis.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
2. Proulx F, Fayon M, Farrell CA, Lacroix J, Gauthier M. Epidemiology of sepsis and multiple organ dysfunction syndrome in children. Chest. 1996;109:1033-7.
3. Standage SW, Wong HR. Biomarkers for pediatric sepsis and septic shock. Expert Rev Anti Infect Ther. 2011;9:71-9.
4. Kaplan JM, Wong HR. Biomarker discovery and development in pediatric critical care medicine. Pediatr Crit Care Med. 2011;12:165-73.
5. Ventetuolo CE, Levy MM. Biomarkers: diagnosis and risk assessment in sepsis. Clin Chest Med. 2008;29:591-603.
6. Rey C, Los Arcos M, Concha A. Procalcitonin as diagnostic and prognostic marker in critically ill children. Eur Pediatr. 2010;4:62-5.
7. Pierrakos C, Vincent JL. Sepsis biomarkers: a review. Crit Care. 2010;14:1-18.
8. Castelli GP, Pognani C, Meisner M, Stuani A, Bellomi D, Sgarbi L. Procalcitonin and C-reactive protein during systemic inflammatory response syndrome, sepsis and organ dysfunction. Crit Care. 2004;8:234-42.
9. Leteurtre S, Martinot A, Duhamel A, Gauvin F, Grandbastien B, Nam TV, et al. Development of a pediatric multiple organ dysfunction score: use of two strategies. Med Decis Making. 1999;19:399-410.
10. Leclerc F, Leteurtre S, Duhamel A, Grandbastien B, Proulx F, Martinot A, et al. Cumulative influence of organ dysfunctions and septic state on mortality of critically ill children. Am J Respir Crit Care Med. 2005;171:348-53.
11. Jensen JU, Heslet L, Jensen TH, Espersen K, Steffensen P, Tvede M. Procalcitonin increase in early identification of critically ill patients at high risk of mortality. Crit Care Med. 2006;34:2596-602.
12. Jat KR, Jhamb U, Gupta VK. Serum lactate levels as the predictor of outcome in pediatric septic shock. Indian J Crit Care Med. 2011;15:102-7.
13. Aikawa N, Fujishima S, Endo S, Sekine I, Kogawa K, Yamamoto Y. Multicenter prospective study of procalcitonin as an indicator of sepsis. J Infect Chemother. 2005;11:152-9.
14. Hendra, Runtunuwu AL, Manoppo JIC. Pediatric logistic organ dysfunction (PELOD) score as prognosis of multiple organ failure in sepsis. Paediatr Indones. 2010;50:226- 32.
15. Leteurtre S, Duhamel A, Grandbastien B, Proulx F, Cotting J, Gottesman R, et al. Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children. CMAJ. 2010;182:1181-7.
16. Hatherill M, Tibby SM, Turner C, Ratnavel N, Murdoch IA. Procalcitonin and cytokine levels: relationship to organ failure and mortality in pediatric septic shock. Crit Care Med. 2000;28:2591-4.
17. Han YY, Doughty LA, Kofos D, Sasser H, Carcillo JA. Procalcitonin is persistently increased among children with poor outcome from bacterial sepsis. Pediatr Crit Care Med. 2003;4:21-5.
18. Budi AD, Rosalina R, Sekarwana N. Hubungan kadar laktat plasma dengan derajat disfungsi organ berdasarkan skor PELOD pada anak sakit kritis. Sari Pediatri. 2008; 10:280-4.
19. Duke TD, Butt W, South M. Predictors of mortality and multiple organ failure in children with sepsis. Intensive Care Med. 1997;23:684-92.