Solé-Ribalta Anna, Bobillo-Pérez Sara, Jordan-García Iolanda
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, 08950 Esplugues de Llobregat, Barcelona, Spain.
Children (Basel). 2022 Aug 6;9(8):1181. doi: 10.3390/children9081181.
Adrenomedullin has several properties. It acts as a potent vasodilator, has natriuretic effects, and reduces endothelial permeability. It also plays a role in initiating the early hyperdynamic phase of sepsis. Since its discovery, many articles have been published studying the uses and benefits of this biomarker. The aim of this review is to determine the usefulness of adrenomedullin in pediatric patients. Relevant studies covering adrenomedullin in pediatrics (<18 years) and published up until August 2021 were identified through a search of MEDLINE, PubMed, Embase, Web of Science, Scopus, and Cochrane. Seventy studies were included in the present review, most of them with a low level of evidence (IV to VI). Research on adrenomedullin has primarily been related to infection and the cardiovascular field. The performance of adrenomedullin to quantify infection in children seems satisfactory, especially in sepsis. In congenital heart disease, this biomarker seems to be a useful indicator before, during, and after cardiopulmonary bypass. Adrenomedullin seems to be useful in the pediatric population for a large variety of pathologies, especially regarding infection and cardiovascular conditions. However, it should be used in combination with other biomarkers and clinical or analytical variables, rather than as a single tool.
肾上腺髓质素具有多种特性。它是一种强效血管舒张剂，具有利钠作用，并可降低内皮通透性。它还在脓毒症早期高动力阶段的启动过程中发挥作用。自其被发现以来，已经发表了许多研究这种生物标志物用途和益处的文章。本综述的目的是确定肾上腺髓质素在儿科患者中的有用性。通过检索MEDLINE、PubMed、Embase、科学网、Scopus和Cochrane数据库，确定了截至2021年8月发表的有关儿科（<18岁）肾上腺髓质素的相关研究。本综述纳入了70项研究，其中大多数证据水平较低（IV至VI级）。对肾上腺髓质素的研究主要与感染和心血管领域相关。肾上腺髓质素在量化儿童感染方面的表现似乎令人满意，尤其是在脓毒症中。在先天性心脏病中，这种生物标志物似乎是体外循环前、期间和后的一个有用指标。肾上腺髓质素似乎在儿科人群中对多种病症有用，尤其是在感染和心血管疾病方面。然而，它应与其他生物标志物以及临床或分析变量联合使用，而不是作为单一工具使用。
