Children's Intensive Care Unit, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Intensive Care Med. 2013 Apr;39(4):747-53. doi: 10.1007/s00134-013-2825-z. Epub 2013 Jan 24.
Levels of vasopressin and its precursor copeptin in pediatric sepsis and septic shock are not well defined. The main aim of this study is to compare the serum levels of vasopressin and copeptin in children with septic shock or sepsis and in healthy children. We hypothesized that vasopressin and copeptin levels are elevated in early and late stages of pediatric septic shock.
Three groups were included: healthy children, children with clinical diagnosis of sepsis, and children admitted to the pediatric intensive care unit (PICU) with diagnosis of sepsis shock. Blood samples were drawn from children in all groups within 24 h of admission. For the septic shock group, additional samples at 24-h intervals were drawn up to 120 h after PICU admission. We used competitive immunoassays to determine vasopressin and copeptin levels.
There were 70 children in the control group, 53 children in the sepsis group, and 13 in the septic shock group. At baseline, there was a difference in median vasopressin levels [60.9 (Interquartile range: 32.3, 138.0) vs. 141.1 (45.2, 542) vs. 326 (55.6, 399) pg/mL, p < 0.05], but there was no difference in copeptin levels [1.2 (0.8, 1.8) vs. 1.5 (1.0, 2.2) vs. 0.9 (0.8, 1.2) ng/mL, p = 0.14] between the three groups. There was no difference in vasopressin and copeptin levels in early and late stages of pediatric septic shock.
Baseline vasopressin levels were different between the three groups. In pediatric septic shock, vasopressin and copeptin levels are not robust markers for severity and clinical outcomes.
在儿科脓毒症和感染性休克中，血管加压素及其前体 copeptin 的水平尚未得到明确界定。本研究的主要目的是比较患有感染性休克或脓毒症的儿童与健康儿童的血清血管加压素和 copeptin 水平。我们假设血管加压素和 copeptin 水平在儿科感染性休克的早期和晚期升高。
共纳入三组：健康儿童、临床诊断为脓毒症的儿童和入住儿科重症监护病房（PICU）诊断为感染性休克的儿童。所有组别的儿童均在入院后 24 小时内采集血液样本。对于感染性休克组，在 PICU 入院后 24 小时间隔内采集额外样本，直至 120 小时。我们使用竞争性免疫测定法来确定血管加压素和 copeptin 水平。
对照组有 70 名儿童，脓毒症组有 53 名儿童，感染性休克组有 13 名儿童。在基线时，血管加压素水平存在差异[60.9（四分位距：32.3，138.0）与 141.1（45.2，542）与 326（55.6，399）pg/ml，p<0.05]，但 copeptin 水平无差异[1.2（0.8，1.8）与 1.5（1.0，2.2）与 0.9（0.8，1.2）ng/ml，p=0.14]。在儿科感染性休克的早期和晚期，血管加压素和 copeptin 水平没有差异。
三组之间的基线血管加压素水平不同。在儿科感染性休克中，血管加压素和 copeptin 水平不是严重程度和临床结局的可靠标志物。
