Development of metabolic and inflammatory mediator biomarker phenotyping for early diagnosis and triage of pediatric sepsis

Critical Care : the Official Journal of the Critical Care Forum
Beata MickiewiczAlberta Sepsis Network

Abstract

The first steps in goal-directed therapy for sepsis are early diagnosis followed by appropriate triage. These steps are usually left to the physician's judgment, as there is no accepted biomarker available. We aimed to determine biomarker phenotypes that differentiate children with sepsis who require intensive care from those who do not. We conducted a prospective, observational nested cohort study at two pediatric intensive care units (PICUs) and one pediatric emergency department (ED). Children ages 2-17 years presenting to the PICU or ED with sepsis or presenting for procedural sedation to the ED were enrolled. We used the judgment of regional pediatric ED and PICU attending physicians as the standard to determine triage location (PICU or ED). We performed metabolic and inflammatory protein mediator profiling with serum and plasma samples, respectively, collected upon presentation, followed by multivariate statistical analysis. Ninety-four PICU sepsis, 81 ED sepsis, and 63 ED control patients were included. Metabolomic profiling revealed clear separation of groups, differentiating PICU sepsis from ED sepsis with accuracy of 0.89, area under the receiver operating characteristic curve (AUROC) of 0.96 (standard deviation [SD] ...Continue Reading

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Citations

May 17, 2017·Critical Care Medicine·Timothy E Sweeney, Purvesh Khatri
Jun 21, 2017·Pharmacotherapy·Michelle EckerleKathleen A Stringer
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Aug 31, 2021·PloS One·Ana Sofía Herrera-Van OostdamYamilé López-Hernández
Jan 29, 2019·The Journal of Pediatrics·Tellen D BennettMichael G Kahn
Oct 19, 2021·Frontiers in Pediatrics·Sherry L KauschJessica Keim-Malpass

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Methods Mentioned

BETA
bronchoalveolar lavage
sedation
blood culture draw
nuclear magnetic resonance
NMR
PCA
metabolomic profiling
enzyme-linked immunosorbent assay

Software Mentioned

Metz ROC
SIMCA
P +
OPLS
DA

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