Biban Paolo, Teggi Martina, Gaffuri Marcella, Santuz Pierantonio, Onorato Diletta, Carpenè Giovanni, Gregori Dario, Lippi Giuseppe
Pediatric Intensive Care Unit, Division of Pediatric Critical and Emergency Care, Verona University Hospital, Verona, Italy.
Section of Clinical Biochemistry, University of Verona, Verona, Italy.
Front Pediatr. 2021 Mar 8;9:642377. doi: 10.3389/fped.2021.642377. eCollection 2021.
Innovative Cell Population Data (CPD) have been used as early biomarkers for diagnosing sepsis in adults. We assessed the usefulness of CPD in pediatric patients with sepsis/septic shock, in terms of early recognition and outcome prediction. We revised 54 patients (0-15 y) admitted to our Pediatric Intensive Care Unit (PICU) for sepsis/septic shock during a 4-year period. Twenty-eight patients were excluded, 26 septic patients were enrolled (G1). Forty children admitted for elective surgery served as controls (G2). Data on five selected CPD parameters, namely neutrophils fluorescence intensity (NE-SFL), monocytes cells complexity (MO-X), monocytes fluorescence intensity (MO-Y), monocytes complexity and width of dispersion of events measured (MO-WX), and monocytes cells size and width dispersion (MO-WZ), were obtained at time of PICU admission () by a hematological analyzer (Sysmex XN 9000®). As the primary outcome we evaluated the relevance of CPD for diagnosing sepsis/septic shock on PICU admission. Furthermore, we investigated if CPD at were correlated with C-reactive protein (CRP), patient survival, or complicated sepsis course. On PICU admission (), NE-SFL, MO-WX, and MO-Y were higher in sepsis/septic shock patients compared to controls. NE-SFL values were correlated with CRP values in G1 patients ( = 0.83). None of the five CPD parameters was correlated with survival or complicated sepsis course. We found higher values of NE-SFL, MO-WX, and MO-Y in children with sepsis/septic shock upon PICU admission. These parameters may be a promising adjunct for early sepsis diagnosis in pediatric populations. Larger, prospective studies are needed to confirm our preliminary observations.
创新细胞群体数据（CPD）已被用作诊断成人脓毒症的早期生物标志物。我们评估了CPD在儿童脓毒症/脓毒性休克患者中对于早期识别和预后预测的有用性。我们回顾了4年间入住我院儿科重症监护病房（PICU）的54例脓毒症/脓毒性休克患儿（0 - 15岁）。排除28例患者，纳入26例脓毒症患者（G1组）。40例择期手术患儿作为对照组（G2组）。在PICU入院时（），通过血液分析仪（Sysmex XN 9000®）获取五个选定的CPD参数数据，即中性粒细胞荧光强度（NE - SFL）、单核细胞细胞复杂性（MO - X）、单核细胞荧光强度（MO - Y）、单核细胞复杂性和测量事件的离散宽度（MO - WX）以及单核细胞细胞大小和宽度离散度（MO - WZ）。作为主要结局，我们评估了CPD在PICU入院时对诊断脓毒症/脓毒性休克的相关性。此外，我们研究了时的CPD是否与C反应蛋白（CRP）、患者生存率或脓毒症复杂病程相关。在PICU入院时（），脓毒症/脓毒性休克患者的NE - SFL、MO - WX和MO - Y高于对照组。G1组患者的NE - SFL值与CRP值相关（ = 0.83）。五个CPD参数均与生存率或脓毒症复杂病程无关。我们发现脓毒症/脓毒性休克患儿在PICU入院时NE - SFL、MO - WX和MO - Y值较高。这些参数可能是儿科人群早期脓毒症诊断的有前景的辅助指标。需要更大规模的前瞻性研究来证实我们的初步观察结果。
