Jariyasakoolroj Theerapon, Chattipakorn Siriporn C, Chattipakorn Nipon
Division of Pediatric Critical Care Medicine, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Pediatr Res. 2024 Jun 4. doi: 10.1038/s41390-024-03289-y.
Pediatric sepsis is a serious issue globally and is a significant cause of illness and death among infants and children. Refractory septic shock and multiple organ dysfunction syndrome are the primary causes of mortality in children with sepsis. However, there is incomplete understanding of mechanistic insight of sepsis associated organ dysfunction. Biomarkers present during the body's response to infection-related inflammation can be used for screening, diagnosis, risk stratification/prognostication, and/or guidance in treatment decision-making. Research on biomarkers in children with sepsis can provide information about the risk of poor outcomes and sepsis-related organ dysfunction. This review focuses on clinically used biomarkers associated with immune dysregulation and organ dysfunction in pediatric sepsis, which could be useful for developing precision medicine strategies in pediatric sepsis management in the future. IMPACT: Sepsis is a complex syndrome with diverse clinical presentations, where organ dysfunction is a key factor in morbidity and mortality. Early detection of organ complications is vital in sepsis management, and potential biomarkers offer promise for precision medicine in pediatric cases. Well-designed studies are needed to identify phase-specific biomarkers and improve outcomes through more precise management.
小儿脓毒症是一个全球性的严重问题，是婴幼儿患病和死亡的重要原因。难治性感染性休克和多器官功能障碍综合征是脓毒症患儿死亡的主要原因。然而，对于脓毒症相关器官功能障碍的机制认识尚不完全。机体对感染相关炎症反应过程中出现的生物标志物可用于筛查、诊断、风险分层/预后评估，和/或指导治疗决策。对脓毒症患儿生物标志物的研究可以提供有关不良结局风险和脓毒症相关器官功能障碍的信息。本综述重点关注小儿脓毒症中与免疫失调和器官功能障碍相关的临床应用生物标志物，这可能有助于未来制定小儿脓毒症精准医疗策略。影响：脓毒症是一种临床表现多样的复杂综合征，其中器官功能障碍是发病和死亡的关键因素。早期发现器官并发症对脓毒症管理至关重要，潜在的生物标志物为小儿脓毒症精准医疗带来希望。需要开展精心设计的研究来识别阶段特异性生物标志物，并通过更精准的管理改善预后。
