Value of Pro-Adrenomedullin in Critically Ill Septic Children in Zagazig University Hospital

Abstract

Introduction: Sepsis is a life-threatening condition which affects many children regardless of some underlying healthcare issues. Assessment risk of mortality in critically ill septic children in pediatric intensive care units (PICUs) can be done by measuring levels of certain new biomarkers. Adrenomedullin (ADM) has been recently proposed as a useful biomarker for evaluating disease severity and risk of death.Objective: The purpose of this study was to measure sensitivity and specificity of ADM in assessment risk of mortality in septic children in comparison to other traditionally used biomarkers in PICUs as CRP and procalcitonin.Method: A prospective Cross sectional study was carried out at pediatric intensive care unit of the pediatric Department and clinical pathology department at Zagazig University Children Hospitals during the period from July 2018 to January 2019 , Thirty eight infant and children patients were recruited in the study ,they were selected from the pediatric intensive care unit population who suffered septicemia ,blood samples withdrawn to measure sepsis markers as ADM , CRP and PCT.Results: There is statistically significant difference between the outcome of the studied patients and our biomarkers CRP, procalcitonin and ADM levels, we found that sensitivity of ADM 83.3%, specificity was 75% PCT sensitivity was 77.8% and specificity was 65% however 72.2% sensitivity, 65% specificity of CRP.Conclusion: MR-pro-ADM level have shown higher positive-predictive values than PCT and CRP levels with high sensitivity and specificity so , this study came to support MR-pro-ADM as new biomarker in critically ill septic children.