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JOURNAL ARTICLE
Tarek A Abdelaziz, Nehad Ahmed Karam, Weaam Ibrahim Ismail, Nahed Mohamed Ali Askary, Eman Gamal Baz
BACKGROUND: Sepsis is an infection-related systemic inflammatory response that often leads to elevated lactate levels. Monitoring lactate levels during severe sepsis is vital for influencing clinical outcomes. The aim of this study was to assess the association between plasma lactate levels and mortality in children with severe sepsis or septic shock. METHODS: The current prospective study was conducted in the PICU of University Children's Hospital. The International Paediatric Sepsis Consensus Conference criteria for Definitions of Sepsis and Organ Failure in 2005 were used to diagnose patients with sepsis...
May 18, 2024: BMC Pediatrics
#2
JOURNAL ARTICLE
Alok Kumar, Sangeeth Raj, Saurabh Singh, Gurpinder S Ghotra, Nikhil Tiwari
INTRODUCTION: Extra Corporeal Membrane Oxygenation (ECMO) has long been used for cardiorespiratory support in the immediate post-paediatric cardiac surgery period with a 2-3% success as per the ELSO registry. Success in recovery depends upon the optimal delivery of critical care to paediatric patients and a comprehensive healthcare team. METHODOLOGY: The survival benefit of children placed on central veno arterial (VA) ECMO following elective cardiac surgeries for congenital heart disease (n = 672) was studied in a cohort of 29 (4...
April 1, 2024: Annals of Cardiac Anaesthesia
#3
JOURNAL ARTICLE
Wanyu Jia, Xue Zhang, Ruiyang Sun, Peng Li, Daobin Wang, Xue Gu, Chunlan Song
The purpose was to investigate how well age-adjusted modified quick Sequential Organ Failure Assessment (qSOFA) scores paired with blood glucose and lactate levels predict the outcomes of septicemic children in the pediatric intensive care unit (PICU). One hundred children who were diagnosed with sepsis and septic shock in the PICU of Henan Children's Hospital were eligible, and other 20 patients in the same hospital at different times were selected as a validation set. Respiratory rate (RR), heart rate (HR), capillary refill time (CRT), and Alert, Voice, Pain, Unresponsive (AVPU) scale were included in the age-adjusted modified qSOFA scoring criteria for scoring...
December 2024: Annals of Medicine
#4
JOURNAL ARTICLE
Viresh S Swami, Lalitha A V, Santu Ghosh, Mounika Reddy
There is a paucity of literature on the prevalence, predictors, prognostic markers, and outcomes of sepsis-induced myocardial dysfunction (SMD) in pediatric septic shock. The objectives of our study were to estimate the prevalence of SMD in pediatric septic shock by point-of-care functional echocardiography (POCFE) and to study the association of SMD with severity of illness, organ dysfunctions, and outcomes. This prospective, observational study was conducted over a period of 1 year (from July 2018 to July 2019) in a 12-bed, tertiary pediatric intensive care unit (PICU) of an academic and referral hospital in South India...
March 2024: Journal of Pediatric Intensive Care
#5
JOURNAL ARTICLE
Theodor S Sigurdsson, Emilie Øberg, Janne Roshauw, Bryndis Snorradottir, Lars Broksø Holst
BACKGROUND: Transfusion of red blood cells (RBC) to rapidly increase hemoglobin levels have been associated with increased risks and worse outcomes in critically ill children. The international TAXI consensus from 2018 (pediatric critical care transfusion and anemia expertise initiative) recommended restrictive RBC transfusion strategies in pediatric patients. OBJECTIVE: To elucidate physicians perioperative RBC transfusion trigger strategies for pediatric patients in the Nordic countries and to investigate what factors influence the decision to transfuse this group of patients...
March 28, 2024: Acta Anaesthesiologica Scandinavica
#6
JOURNAL ARTICLE
B Palalıoğlu, S Erdoğan, G Atay, H C Tugrul, Ö F Özer
INTRODUCTION AND PURPOSE: In this prospective study, we aim to evaluate the effects of antibiotherapy on pentraxin-3 (PTX3), C-reactive protein (CRP), and interleukin-6 (IL-6) levels in patients with sepsis and septic shock. MATERIALS AND METHODS: In our study, CRP, procalcitonin, IL-6, and PTX3 levels at initial and 48 hours of the antibiotherapy of patients who were admitted to the pediatric intensive care unit (PICU) with the diagnosis of sepsis and septic shock between June 2020 and March 2021 were compared...
March 1, 2024: Nigerian Journal of Clinical Practice
#7
JOURNAL ARTICLE
Asmaa Mhanna, Azizullah Beran, Omar Srour, Mohammed Mhanna, Ahmad Assaly, Abdelrahman Elsayed, Nicholas G Horen, Ragheb Assaly
PURPOSE: We conducted a comprehensive meta-analysis to compare the effects of balanced crystalloids (BC) and isotonic saline (IS) in pediatric sepsis. METHODS: A systematic search was performed for studies comparing BC and IS in pediatric sepsis. Outcomes included mortality, acute kidney injury (AKI), need for renal replacement therapy (RRT), hospital length of stay (LOS), and pediatric intensive care unit (PICU) LOS. A random-effect models was used to calculated pooled odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CIs)...
2024: Proceedings of the Baylor University Medical Center
#8
JOURNAL ARTICLE
Jhuma Sankar, Sheetal Agarwal, Anshu Goyal, S K Kabra, Rakesh Lodha
OBJECTIVES: To describe mortality associated with different clinical phenotypes of sepsis in children. DESIGN: Retrospective study. SETTING: PICU of a tertiary care center in India from 2017 to 2022. PATIENTS: Six hundred twelve children (from 2 mo to 17 yr old) with a retrospectively applied diagnosis of sepsis using 2020 guidance. METHODS: The main outcome was mortality associated with sepsis subtypes...
April 1, 2024: Pediatric Critical Care Medicine
#9
JOURNAL ARTICLE
Marijo N Aguilera, Sandra Hoffman, Whitney Wunderlich, David Watson, Marc Vacquier, Abbey Sidebottom
OBJECTIVE: To determine whether lactate levels were associated with maternal infection and infection-related outcomes in the antepartum, intrapartum, and early postpartum periods. DESIGN: Retrospective, observational cohort. SETTING: Eleven hospitals from a single health system. PARTICIPANTS: Women (N = 783) with at least one lactate and blood culture test for obstetric sepsis screening in the antepartum period (n = 154), intrapartum period (n = 348), and early postpartum period (n = 281) from January 2, 2018, to October 21, 2020...
January 25, 2024: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
#10
JOURNAL ARTICLE
Luregn J Schlapbach, R Scott Watson, Lauren R Sorce, Andrew C Argent, Kusum Menon, Mark W Hall, Samuel Akech, David J Albers, Elizabeth R Alpern, Fran Balamuth, Melania Bembea, Paolo Biban, Enitan D Carrol, Kathleen Chiotos, Mohammod Jobayer Chisti, Peter E DeWitt, Idris Evans, Cláudio Flauzino de Oliveira, Christopher M Horvat, David Inwald, Paul Ishimine, Juan Camilo Jaramillo-Bustamante, Michael Levin, Rakesh Lodha, Blake Martin, Simon Nadel, Satoshi Nakagawa, Mark J Peters, Adrienne G Randolph, Suchitra Ranjit, Margaret N Rebull, Seth Russell, Halden F Scott, Daniela Carla de Souza, Pierre Tissieres, Scott L Weiss, Matthew O Wiens, James L Wynn, Niranjan Kissoon, Jerry J Zimmerman, L Nelson Sanchez-Pinto, Tellen D Bennett
IMPORTANCE: Sepsis is a leading cause of death among children worldwide. Current pediatric-specific criteria for sepsis were published in 2005 based on expert opinion. In 2016, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, but it excluded children. OBJECTIVE: To update and evaluate criteria for sepsis and septic shock in children...
February 27, 2024: JAMA
#11
JOURNAL ARTICLE
Jing Lu, Liqun Dong, Lijuan Zhang, Yannan Guo, Hanmin Liu, Yang Liu
BACKGROUND: Acute kidney injury (AKI) is common in children with sepsis, chronic kidney disease, poisoning or other conditions. Wasp stings are recognized as an important etiology. Several retrospective studies have investigated AKI after wasp stings in adults, but research on children remains limited. METHODS: The study included 48 children with multiple organ dysfunction syndrome after wasp stings. Demographic data, clinical manifestations, laboratory findings, management and clinical outcomes were collected, and analyzed to identify early indicators or risk factors for AKI...
January 10, 2024: Pediatric Nephrology
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JOURNAL ARTICLE
Juan B Dartiguelongue
Sepsis is a global health problem; progression to septic shock is associated with a marked increase in morbidity and mortality. In this setting, increased plasma lactate levels demonstrated to be an indicator of severity and a predictor of mortality, and are usually interpreted almost exclusively as a marker of low tissue perfusion. However, a recent paradigm shift has occurred in the exegesis of lactate metabolism and its biological properties. Indeed, metabolic adaptation to stress, even with an adequate oxygen supply, may account for high circulating lactate levels...
April 1, 2024: Archivos Argentinos de Pediatría
#13
RANDOMIZED CONTROLLED TRIAL
Dabin Huang, Chuming You, Xiaowei Mai, Lin Li, Qiong Meng, Zhenyu Liang
UNLABELLED: This randomized controlled trial aimed to determine whether lung ultrasound-guided fluid resuscitation improves the clinical outcomes of neonates with septic shock. Seventy-two patients were randomly assigned to undergo treatment with lung ultrasound-guided fluid resuscitation (LUGFR), or with usual fluid resuscitation (Control) in the first 6 h since the start of the sepsis treatment. The primary study outcome was 14-day mortality after randomization. Fourteen-day mortalities in the two groups were not significantly different (LUGFR group, 13...
March 2024: European Journal of Pediatrics
#14
JOURNAL ARTICLE
Halden F Scott, Daniel M Lindberg, Savannah Brackman, Erin McGonagle, Jan E Leonard, Kathleen Adelgais, Lalit Bajaj, Mairead Dillon, Allison Kempe
STUDY OBJECTIVE: To assess whether a general emergency department's (ED) annual pediatric sepsis volume increases the odds of delivering care concordant with Surviving Sepsis pediatric guidelines. METHODS: A retrospective cohort study of children <18 years with sepsis presenting to 29 general EDs. Emergency department and hospital data were abstracted from the medical records of 2 large health care systems, including all hospitals to which children were transferred...
December 7, 2023: Annals of Emergency Medicine
#15
JOURNAL ARTICLE
Gazi Arslan, Tolga Besci, Göktuğ Özdemir, Gültaç Evren, Hande Ilgaz Tüzen, Pınar Prencuva, Bengisu Turan, Ebru Melek Benligül
The accurate prediction of the prognosis for critically ill children is crucial, with the Pediatric Index of Mortality (PIM) and Pediatric Risk of Mortality (PRISM) being extensively utilized for this purpose. Albumin, C-reactive protein (CRP), and lactate levels, which are indicative of inflammation and circulatory status in critically ill children, have not been incorporated into existing scoring systems. This retrospective cohort study evaluated the association between biological markers and the clinical outcomes in children with critical illnesses...
October 26, 2023: Children
#16
JOURNAL ARTICLE
Jinglin Xu, Yifan Sun, Weifeng Zhang, Xiaoyun Chu, Hongyuan Yang, Cheng Cai, Dongmei Chen
To investigate the efficacy and safety of continuous blood purification (CBP) in neonates with septic shock and acute kidney injury (AKI). This retrospective study was conducted at two tertiary care children's hospitals between January 2015 and May 2022. A total of 26 neonates with septic shock and AKI were included in this study, with a mortality rate of 50%. Fourteen neonates (53.8%) received continuous veno-venous hemodiafiltration, and 12 (46.2%) received continuous veno-venous hemofiltration. Compared with the indices before CBP, urine output increased 12 h after CBP initiation (P = 0...
November 16, 2023: European Journal of Pediatrics
#17
JOURNAL ARTICLE
Hatice Feray Arı, Adem Keskin, Murat Arı, Recai Aci
Aim: To evaluate the lactate/albumin ratio and its relation to mortality in children with nosocomial infections. Materials & methods: One hundred six children were included in this study. Blood gas and albumin levels were analyzed at the first, 24th and 48th h. Results: The types of detected microbial agents, signs of sepsis, development of septic shock and mortality rates were different. The first-, 24th- and 48th h lactate levels of the children who died were higher than those of the living children, but the albumin levels were lower...
November 14, 2023: Future Microbiology
#18
JOURNAL ARTICLE
Ekin Soydan, Mehmet Murat, Ceren Karahan, Ahmet Gonullu, Yigit Aksoy, Gokhan Ceylan, Sevgi Topal, Mustafa Colak, Pınar Seven, Ozlem Sarac Sandal, Gulhan Atakul, Utku Karaarslan, Hasan Agın
Pediatric septic shock is defined as progressive multi-organ dysfunction and cardiovascular dysfunction accompanying sepsis. Studies showing myocardial dysfunction associated with pediatric septic shock are very limited. The aim of this study was to evaluate the relationship between myocardial functions calculated by echocardiography, disease severity, and clinical outcomes in children with septic shock. This observational prospective study was conducted in a pediatric intensive care at a university-affiliated tertiary hospital...
October 4, 2023: European Journal of Pediatrics
#19
REVIEW
Jaime Fernández-Sarmiento, Carolina Casas-Certain, Sarah Ferro-Jackaman, Fabian H Solano-Vargas, Jesús Ángel Domínguez-Rojas, Francisco Javier Pilar-Orive
Fluid resuscitation with crystalloids has been used in humans for more than 100 years. In patients with trauma, sepsis or shock of any etiology, they can help modify the clinical course of the illness. However, these solutions are medications which are not side-effect free. Recently, they have been questioned in terms of quantity (fluid overload) and their composition. The most frequently used crystalloids, both in high and low-income countries, are 0.9% normal saline (NS) and Ringer's lactate. The first descriptions of the use of sodium and water solutions in humans date from the cholera epidemic which spread throughout Europe in 1831...
2023: Frontiers in Pediatrics
#20
JOURNAL ARTICLE
Li Wu, Ming Jin, Ruiqing Wang, Lihua Yang, Xiaorong Lai, Lihua Yu, Danna Lin, Lulu Huang, Yajie Zhang, Jingxin Zhang, Xu Liao, Juan Zi, Yuting Yuan, Yinghua Zeng, Ming Cheng, Shaohua Tao
OBJECTIVE: To analyze the prognostic factors of sepsis in children with acute leukemia admitted to the pediatric intensive care unit (PICU) and to compare the efficacy of different scoring systems for predicting the outcome of children. METHODS: Patients with an acute leukemia diagnosis admitted to a tertiary care university hospital PICU due to sepsis during chemotherapy between May 2015 and August 2022 were retrospectively analyzed through an electronic medical record system...
June 7, 2023: Pediatric Blood & Cancer
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