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Lactate, sepsis, pediatrics

Marianne E Nellis, Steven Pon, Ashley E Giambrone, Nana E Coleman, Jonathan Reiss, Elizabeth Mauer, Bruce M Greenwald
BACKGROUND: Bacterial sepsis is frequently encountered in children admitted to the Pediatric Intensive Care Unit (PICU) and requires early recognition and treatment. Procalcitonin (PCT) is a serum biomarker with a high sensitivity to predict bacteremia in critically-ill adults. This study sought to evaluate the diagnostic accuracy of PCT for bacteremia in febrile children in the PICU. METHODS: This retrospective observational study used data from children admitted to the PICU from October 2010 to October 2012...
November 2016: Infectious Diseases in Clinical Practice: IDCP
Halden Scott, Lina Brou, Sara Deakyne, Lalit Bajaj
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Jaime Fernández Sarmiento, Paula Araque, María Yepes, Hernando Mulett, Ximena Tovar, Fabio Rodriguez
Introduction. Lactate is an important indicator of tissue perfusion. The objective of this study is to evaluate if there are significant differences between the arterial and central venous measurement of lactate in pediatric patients with sepsis and/or septic shock. Methods. Longitudinal retrospective observational study. Forty-two patients were included between the age of 1 month and 17 years, with a diagnosis of sepsis and septic shock, who were admitted to the intensive care unit of a university referral hospital...
2016: Critical Care Research and Practice
(no author information available yet)
OBJECTIVE: To observe the occurrence rate of elevated serum amylase and lipase in critically ill children, to explore the relationship between elevated pancreatic enzymes and pancreatic injury, and the effect of elevated pancreatic enzymes on state of illness and the prognosis. METHOD: The data of cases treated in pediatric intensive care unit(ICU) of 17 children's hospitals were collected prospectively from January 2012 to March 2014 according to the inclusion and exclusion criteria...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Jean-Louis Vincent, Amanda Quintairos E Silva, Lúcio Couto, Fabio S Taccone
BACKGROUND: The time course of blood lactate levels could be helpful to assess a patient's response to therapy. Although the focus of published studies has been largely on septic patients, many other studies have reported serial blood lactate levels in different groups of acutely ill patients. METHODS: We performed a systematic search of PubMed, Science Direct, and Embase until the end of February 2016 plus reference lists of relevant publications. We selected all observational and interventional studies that evaluated the capacity of serial blood lactate concentrations to predict outcome...
August 13, 2016: Critical Care: the Official Journal of the Critical Care Forum
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Bereketeab Haileselassie, Erik Su, Iraklis Pozios, Teresa Fiskum, Reid Thompson, Theodore Abraham
OBJECTIVES: In the progression of severe sepsis, sepsis-induced myocardial dysfunction contributes to severity of illness and ultimate mortality. Identification of sepsis-induced myocardial dysfunction causing depressed cardiac function during critical illness has implications for ongoing patient management. However, assessing pediatric cardiac function traditionally relies on echocardiographic qualitative assessment and measurement of left ventricular ejection fraction or fractional shortening...
May 2016: Pediatric Critical Care Medicine
Halden F Scott, Lina Brou, Sara J Deakyne, Diane L Fairclough, Allison Kempe, Lalit Bajaj
OBJECTIVES: To evaluate whether lactate clearance and normalization during emergency care of pediatric sepsis is associated with lower rates of persistent organ dysfunction. STUDY DESIGN: This was a prospective cohort study of 77 children <18 years of age in the emergency department with infection and acute organ dysfunction per consensus definitions. In consented patients, lactate was measured 2 and/or 4 hours after an initial lactate; persistent organ dysfunction was assessed through laboratory and physician evaluation at 48 hours...
March 2016: Journal of Pediatrics
Michaela Döring, Karin Melanie Cabanillas Stanchi, Judith Feucht, Manon Queudeville, Heiko-Manuel Teltschik, Peter Lang, Tobias Feuchtinger, Rupert Handgretinger, Ingo Müller
Diagnosis of adverse events following hematopoietic stem cell transplantation (HSCT) is mainly assigned to clinical symptoms or biopsies and thus rather unspecific and/or invasive. Studies indicate a distinct role of serum ferritin in HSCT and its correlation with adverse events such as graft-versus-host disease (GvHD), veno-occlusive disease (VOD), or infections. However, published data on the relevance of ferritin as a prognostic marker for post-transplant adverse events is rare, especially in pediatric patients...
January 2016: Annals of Hematology
Noelle Gorgis, Cynthia Fontana, Jeanette Asselin, Robert Heidersbach, Heidi Flori, Shan Ward
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Raúl Bustos B, Oslando Padilla P
INTRODUCTION: The use of biomarkers could be a tool for diagnosis, prognosis and stratifying children with sepsis. Our main goal was to analyze the value of procalcitonin (PCT), C reactive protein (CRP) and lactate in predicting mortality, septic shock and the stratification in children with suspected sepsis PATIENTS AND METHOD: Prospective study in 81 patients. Plasma levels of PCT, CRP and lactate were measured at admission in the pediatric intensive care unit...
September 2015: Revista Chilena de Pediatría
Juan Qian, Ying Wang, Yucai Zhang, Xiaodong Zhu, Qunfang Rong, Hongxia Wei
BACKGROUND: Application of the sepsis resuscitation bundle is limited by clinician knowledge, skills, and experience. We used the adjusted first-hour basic care tasks in pediatric patients in three tertiary hospitals in Shanghai, China. OBJECTIVE: The aim of this study is to survey the compliance of the adjusted tasks and to evaluate in situ simulation team training on improving the compliance. METHODS: A prospective observational study was performed with the survey checklists from May 2011 to January 2012 in three pediatric intensive care units...
February 2016: Journal of Emergency Medicine
Graham C Thompson, Charles G Macias
BACKGROUND: Pediatric sepsis remains a leading cause of morbidity and mortality. Understanding current practice patterns and challenges is essential to inform future research and education strategies. OBJECTIVE: Our aim was to describe the practice patterns of pediatric emergency physicians (PEPs) in the recognition and management of sepsis in children and to identify perceived priorities for future research and education. METHODS: We conducted a cross-sectional, internet-based survey of members of the American Academy of Pediatrics, Section on Emergency Medicine and Pediatric Emergency Research Canada...
October 2015: Journal of Emergency Medicine
Prerna Batra, Ajeet Kumar Dwivedi, Neha Thakur
Point of care testing, is the term commonly applied to the bedside tests performed in sick patients. Common clinical conditions encountered in pediatric emergency rooms are respiratory, gastro-intestinal, infections and cardiac. Emergencies at most of the places, especially developing countries are overburdened. Availability of tests like arterial blood gas, lactate, electrolytes and procalcitonin, bedside tests or point of care tests can help identify sick patients quickly. Abnormalities like acid-base disturbances and dyselectrolytemias can be dealt with instantly, thus improving the overall prognosis...
July 2014: International Journal of Critical Illness and Injury Science
Jeremie Rousseaux, Bruno Grandbastien, Aimée Dorkenoo, Marie Emilie Lampin, Stéphane Leteurtre, Francis Leclerc
OBJECTIVES: Septic shock is frequent in children and is associated with high mortality and morbidity rates. Early recognition of severe sepsis improve outcome. Shock index (SI), ratio of heart rate (HR) and systolic blood pressure (SBP), may be a good noninvasive measure of hemodynamic instability that has been poorly studied in children. The aim of the study was to explore the usefulness of SI as an early index of prognosis for septic shock in children. METHODS: The study was retrospective and performed in 1 pediatric intensive care unit at a university hospital...
October 2013: Pediatric Emergency Care
Du-Fei Zhang, Xiao-Wei Feng, Tao Lin, Kai-Fang Wu
OBJECTIVE: To study risk factors for the occurrence of intra-abdominal hypertension (IAH) in children with sepsis. METHODS: A nest case-control study was employed. According to intra-abdominal pressures (IAP) measured by cystometry, 119 children with sepsis were classified into normal IAP (control, n = 80) and IAH groups (n = 39). Risk factors for the occurrence of IAH were investigated by monovariable and multivariable logistic regression analysis. RESULTS: Monovariable analysis showed that there were significant differences in pediatric critical illness score (PCIS), procalcitonin (PCT) level, PaCO(2), blood lactate level, rates of intestinal or intra-abdominal infection, ascites, gastrointestinal dysfunction, mechanical ventilation, shock and multiple organ dysfunction syndrome (MODS) between the IAH and control groups (P < 0...
July 2013: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Loren Reed, Jennifer Carroll, Antonio Cummings, Stephen Markwell, Jarrod Wall, Myto Duong
OBJECTIVES: No single reliable sepsis biomarker exists for risk stratification and prognostication in pediatric patients presenting to the emergency department (ED). Serum lactate (LA) predicts mortality in septic adults. We sought to determine if serum LA correlated with the diagnosis of sepsis, admission rates, and outcomes in pediatric patients presenting to the ED with suspected infection. METHODS: This retrospective study was performed in an ED with a sepsis protocol that included serum LA with every blood culture...
July 2013: Pediatric Emergency Care
Halden F Scott, Aaron J Donoghue, David F Gaieski, Ronald F Marchese, Rakesh D Mistry
OBJECTIVES: Failure to recognize shock contributes to inadequate early resuscitation in many children with sepsis. Serum lactate levels are used to identify adult patients with septic shock, but physical examination diagnosis alone is recommended in pediatric sepsis. The authors sought to test the utility of lactate testing in pediatric emergency department (ED) patients with systemic inflammatory response syndrome (SIRS). The hypothesis was that early hyperlactatemia (serum lactate ≥ 4...
November 2012: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Paola Papoff, Elena Caresta, Paolo Versacci, Raffaella Pinto, Corrado Moretti, Fabio Midulla
Although international guidelines for hemodynamic support of pediatric septic shock suggest considering the potent calcium sensitizer inodilator levosimendan as a second-line inotropic agent to treat cold hypodynamic shock resistant to catecholamines, clinical experience in septic infants is lacking. We report the beneficial effects of levosimendan infusion in 2 infants (39 and 64 days old) with low cardiac output septic shock (ejection fraction, 29% and 33%; fractional shortening, 10% and 16% respectively) refractory to volume replacement and to the catecholamines dopamine and dobutamine...
October 2012: Pediatric Emergency Care
Xiong Zhou, Zhi-Yue Xu, Jiang-Hua Fan, Wei Huang
OBJECTIVE: To study the relationship between blood lactate level and disease severity in critically ill children. METHODS: The clinical data of 232 children who were critically ill between September and December, 2010 were retrospectively studied. According to blood lactate levels within 24 hrs of admission, the 232 patients were classified into three groups: normal (n=146), high lacticemia (n=72) and lactic acidosis (n=14). The circulation functions, pediatric critical illness scores and prognosis were compared among the three groups...
February 2012: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
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