Jun 10, 2011

Endotoxemia in pediatric critical illness--a pilot study

Critical Care : the Official Journal of the Critical Care Forum
Shamik DholakiaS Nadel

Abstract

The aim was to investigate the prevalence of endotoxemia in children admitted to pediatric intensive care unit (PICU), and its association with disease severity and outcome. We conducted a prospective, observational cohort study of children admitted to PICU at St. Mary's Hospital, London over a 6-month period. One hundred consecutive patients were recruited. Demographic and clinical data were collected. Severity of illness was assessed by the pediatric index of mortality 2 (PIM2) score. The pediatric logistic organ dysfunction (PELOD) score was performed daily for the first 4 days. Patients were categorized according to primary reason for PICU admission. Blood samples were taken within 24 hours of admission and endotoxemia was measured using the endotoxin activity assay (EAA). Patients were stratified according to EAA level (high, EAA > 0.4, low, EAA < 0.4) and categorized as septic, post-surgical, respiratory or other. Data were analyzed using appropriate non-parametric tests. EAA level was significantly lower in PICU controls versus other PICU admissions (P = 0.01). Fifty-five children had endotoxemia on admission. Forty-one (75%) of these were eventually diagnosed with an infectious cause of admission. Nine children without ...Continue Reading

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Citations

Mentioned in this Paper

Septicemia
Pseudomonas Infections
Pediatric Intensive Care Unit
Neisseria meningitidis
Endotoxemia
Ceftriaxone
Haemophilus influenzae
Whole Blood
Lung
Gentamicins

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