Pro-adrenomedullin, pro-endothelin-1, procalcitonin, C-reactive protein and mortality risk in critically ill children: a prospective study

摘要

IntroductionWe tested the hypothesis that higher mid-regional pro-adrenomedullin (MR-proADM), carboxy-terminal pro-endothelin-1 (CT-proET-1), procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations would be associated with increased prediction of mortality risk scores.MethodsProspective observational study set in two pediatric intensive care units (PICUs). Two-hundred-thirty-eight patients were included. MR-proADM, CT-proET-1, PCT and CRP levels were compared between children with PRISM III and PIM 2?>?p75 (Group A; n?=?33) and the rest (Group B; n?=?205).ResultsMedian (range) MR-proADM levels were 1.39?nmol/L (0.52–12.67) in group A versus 0.54 (0.15–3.85) in group B (P??0.79?nmol/L had 93% sensitivity and 76% specificity to differentiate groups, whereas a CT-proET-1?>?123 pmol/L had 77% sensitivity and 84% specificity, and a PCT concentration?>?2.05?ng/mL had 80% sensitivity and specificity.ConclusionsIn critically ill children, high levels of MR-proADM, CT-proET-1 and PCT were associated with increased prediction of mortality risk scores. MR-proADM, CT-proET-1 and PCT concentrations higher than 0.80?nmol/L, 123 pmol/L and 2?ng/mL, respectively, could be used by clinicians to identify critically ill children at higher prediction of risk death scores.