الفهرس 
SepsisOnly 14 pages are availabe for public view
 |  | from | 123 |  |  |
| | | from | 123 | | |
Abstract
Sepsis is a life-threatening condition that arises when the body’s response to infection injures its own tissues and organs. According to the American College of Chest Physicians and the Society of Critical Care Medicine, there are different levels of sepsis: sepsis, severe sepsis, and septic shock.
The mortality rate of SIRS, sepsis, severe sepsis and septic shock is high, ranging from approximately 10% in SIRS to 60% in septic shock. While identification and treatment of sepsis has led to a decrease in mortality, the incidence continues to increase resulting in a still larger number of deaths annually. Worldwide, sepsis is thus the major cause of death in intensive care units (ICU) and therefore an area of concern.
In order to improve the survival of patients with SIRS and sepsis, it is essential to identify the individuals at high risk. One approach for this identification is constantly evaluating reliable biological markers. Diagnostic markers should be able to accurately detect the disease early in its course while prognostic markers must predict the progression of the disease. Procalcitonin and CRP are biological markers currently in clinical use for detection of infection and unspecific inflammation, respectively, in the therapeutic management of SIRS and sepsis
Our aim in this study was to assess reliability of pentrexin 3 as a diagnostic and prognostic value for sepsis in pediatric intensive care unit of Menoufia University.
To achieve this target, we studied a series of 90 subjects (70 cases and 20 children with age and sex matched to the first group,
considered as a control group).This study done at pediatric intensive care unit of Menoufia University. All children incorporated in the study were subjected to: careful history taking, thorough clinical examination and laboratory investigations. PRISM score was calculated within 24hrs of admission for each patient, using the 14th measured clinical and laboratory variables. Data were entered on the website http://www.sfar.org/scores2/prism2.php. Inserting the patient’s age in months in the specified window led to automatic calculation of the predicted death rate.
There was highly significant difference in serum pentrexin3 level among cases than control, sepsis than control, severe sepsis than control, SIRS than severe sepsis and sepsis and severe sepsis than SIRS. Also, there was significant difference in serum pentrexin3 level among SIRS than sepsis and SIRS than severe sepsis.
There was statistically significant positive correlation between Serum pentrexin3 and (Hospital stay, ICU stay PRISM risk mortality and PIM risk mortality).When the cutoff point of Pentrexin3 was 0.9678, its clinical sensitivity was79.6%, its clinical specificity was38.1%, its PPV was 51.9%, its NPP was 88.9%and accuracy was 61.4%.
Conclusion
Pentraxin3 has a diagnostic role in prediction of severity of sepsis (patient subgroup than control, SIRS than sepsis, sepsis than sever sepsis).
The diagnostic accuracy of pentraxin 3 was similar performance as CRP.
It has prognostic value in patient as patient on mechanical ventilation and long stay in hospital.
It has themodest prognostic accuracy but PRISM has the most prognostic.