Prognostic value of nitric oxide in pediatric septic shock
Journal Title: Paediatrica Indonesiana - Year 2016, Vol 56, Issue 4
Abstract
Background Nitric oxide (NO) play a key role in the pathogenesis of septic shock. Nitrit oxide metabolite is reported as a good predictor for shock although its role as mortality predictor in sepsis still controversial.Objective To assess the serum nitric oxide (NO) levels and outcomes in pediatric patients with septic shock.Methods We conducted a prospective cohort study from January 2013 to April 2014 in Pediatric Intensive Care Unit (PICU) Prof. Dr. R. D. Kandou Hospital, Manado. Subjects were patients aged 1 month-12 years diagnosed with septic shock. We measured initial serum NO and observed its outcomes in all subjects.Results A total of 37 patients with septic shock met the study criteria. Nineteen children were male (51.4%). Seventeen subjects died and 20 subjects survived. The mean age of subjects with septic shock was 37.3 (SD 14.2) months. The mean serum NO level was significantly higher in the group who died [33.2 μM; 95% CI 23.6 to 42.7] than in the group who survived [13.8 μM; 95%CI 11.6 to 15.9] (P<0.01). The serum NO cut-off point for predicting mortality was 16.15 µM. For NO levels of more than 16.15 µM, the positive predictive value was 72.2% and negative predictive value was 78.9% (OR 9.750; 95%CI 2.154 to 44.138).Conclusion In pediatric patients with septic shock, serum NO levels are significantly higher in those who died than in those who survived. Serum nitric oxide level can be used to predict outcomes of patients with septic shock.
Authors and Affiliations
Ari Runtunuwu, Jeanette Manoppo, Dasril Daud, Irawan Yusuf, Idham Ganda
Keywords
Related Articles
- EP ID EP446136
- DOI 10.14238/pi56.4.2016.211-4
- Views 81
- Downloads 0
Knowledge, attitude, and behavior of pregnant women on early initiation of breastfeeding
Background Infant mortality rate is an indicator of the degree ofhealth in society. In Indonesia, the infant mortality rate remainshigh, with most deaths occurring in the first 24 hours of life.Breastfeeding has been sho...
Efficacy of synbiotic treatment in children with acute rotavirus diarrhea
Background Diarrhea is one of the major causes of morbidityand mortality in children throughout the world, mostly due torotavirus infection. In daily practice, we routinely use the WorldHealth Organization Five steps for...
Serum interleukin-6 and mean platelet volume in pediatric pneumonia
Background In pneumonia, interleukin (IL)-6 is released in response to inflammation. Interleukin-6 stimulates megakaryocyte maturation, leading to larger platelets being released into the circulation. Platelet size is me...
Serum IGF-1 and short stature in adolescents with beta-thalassemia major
Background The prevalence of short stature in thalassemia patients ranges from 39.3 to 65%. The cause of short stature is complex and still up for d...
Prescribing antibiotics to pediatric dengue: increasing risk of bacterial resistance
Background Use of antibiotics to treat self-limiting viral infections like dengue fever (DF) without any co-morbid conditions in pediatric patients is common practice in India, and a major contribution of the inappropria...