Abstract
Aims & Objectives: To determine the exocrine pancreatic function of critically ill children. Methods: Prospective observational study conducted in the PICU of a tertiary hospital in Madrid, Spain. Children admitted to PICU whose expected PICU length of stay was more than one week were enrolled. Fecal elastase-1, amylase levels were analyzed on admission, day 7 and discharge. Stool samples were taken in the first week of hospitalization to analyze fecal elastase-1 by immunochromatographic tests. Elastase-1 concentration of 1-2 μg/g was considered normal, whereas levels <1 μg/g revealed exocrine pancreas dysfunction. Results: 15 critically ill children were enrolled in the study with a median age of 5 months (IQR 4-20 months). The median PRISM III was 9 (IQR 6-16) and the median length of PICU stay was 15 days (IQR 9-63). Two of them died and only one of them developed diarrhea during the study period. Fecal elastase-1 was collected in 10 children and was normal in all of them. Mean amylase levels on admission, on day 7 and at PICU discharge were 13 U/L (IQR 6.5-41.5), 16 U/L (IQR 4.8-61.5) and 15.5 U/L (IQR 7-44) respectively. Mean lipase levels on admission, on day 7 and at PICU discharge were 11 U/L (IQR 6.8-19.5) 14 U/L (IQR 11-28) and 16.5 U/L (IQR 12.3-36.8). Conclusions: Exocrine pancreatic function seems to be normal during the first week of critical illness in children. More studies including a higher number of patients and using more specific test are required to confirm these results.
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