Is There a Role of Presepsin as a Novel Biomarker in Pediatric Sepsis?

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Simranjeet Singh
2. Nisha Toteja
3. Daisy Khera
4. Prawin Kumar
5. Kuldeep Singh
ISSN
0972-5229
DOI
10.5005/jp-journals-10071-24202
Volume
26
Issue
6
Publishing Year
2022
Pages
5
Author Affiliations
    1. All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
    1. Department of Pediatrics, AIIMS, Gorakhpur, Uttar Pradesh, India
    1. Department of Pediatrics, AIIMS, Jodhpur, Rajasthan, India
    1. All India Institute of Medical Sciences, New Delhi, India
    2. All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
    3. All India Institute of Medical Sciences, Jodhpur, Rajasthan
    1. Prakash Mohalla, East of Kailash, New Delhi 110065 (India)
    2. Pt Bhagwat Dayal Sharma Postgraduate, Institute of Medical Sciences, Rohtak, Haryana, India
    3. Indraprastha Apollo Hospitals, New Delhi, India
    4. New Delhi
    5. All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
    6. New Delhi, India
    7. Dr Kuldeep’s Ultrasound and Color Doppler Clinic, D 80, East of Kailash, New Delhi 110065, India
    8. Dr Kuldeep’s Ultrasound and Color Doppler Clinic, 266, Prakash Mohalla, East of Kailash, New Delhi 110065, India
    9. Sri Aurobindo Institute of Medical Sciences, Indore
    10. Dr Kuldeep’s Ultrasound and Color Doppler Clinic, 266, Prakash Mohalla, East of Kailash, New Delhi
    11. Dr Kuldeep’s Ultrasound and Color Doppler Clinic, D 80, East of Kailash, New Delhi, India, singhdrkuldeep@rediffmail.com
    12. The Ultrasound Lab, New Delhi, India
    13. Dr Kuldeep’s Ultrasound and Color Doppler Clinic, D-115, East of Kailash, New Delhi, India
    14. Dr Kuldeep’s Ultrasound and Color Doppler Clinic, D 80, East of Kailash, New Delhi, India, Email
  • Article keywords

    Abstract

    Background: Sepsis in children is a conundrum of diagnostic and therapeutic challenges. There is an exigent need for a novel biomarker that can serve as a clear distinguisher of sepsis from other non-septic inflammatory conditions. The role of presepsin as a biomarker of sepsis in children is still a matter of scientific inquiry. Aim and objectives: To evaluate the diagnostic accuracy of presepsin for the prediction of septic shock, in children aged 1 month to 18 years. Materials and methods: This prospective cohort study was conducted in the pediatric emergency, ward, and intensive care unit of a tertiary care hospital. We enrolled all consecutive admissions aged 1 month to 18 years with a diagnosis of sepsis and compared the presepsin, procalcitonin, and C-reactive protein (CRP) levels on admission (day 1) and 72 hours later (day 4) with the clinical outcomes. Results: The mean (±SD) presepsin values in blood culture-proven sepsis patients at admission and 72 hours later were 609.77 ± 417.30 and 839 ± 748.07, respectively. The procalcitonin and presepsin levels at 72 hours in sepsis patients with shock were significantly elevated (38.2 ± 45.55 and 1129.1 ± 1133.80, respectively) as compared to those without shock (10.7 ± 25.42 and 472.5 ± 507.81, respectively), p <0.05. The receiver operating characteristic (ROC) curve analysis of presepsin at 72 hours had an area under curve (AUC) of 0.730, suggesting a fair diagnostic accuracy. Conclusion: Elevated presepsin levels may indicate greater severity of sepsis, particularly in those with shock. However, it lacks diagnostic ability early in the disease and has limited prognostic potential in predicting mortality.

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