الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Pediatric sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Unfortunately, 51 - 75% of pediatric sepsis deaths occur within 48 hours of PICU admission.
In spite of the tremendous bad effect of pediatric sepsis on our patients, timely diagnosis is not that easy and even sometimes may be done according to clinical experience or data gathered from adult sepsis. Thus, rapid and accurate diagnosis and consequently appropriate treatment can be delayed making the issue more problematic.
Biomarkers for sepsis are a wide field of research, yet there are very limited studies in pediatrics in comparison with adults or even neonates. Generally, it is very promising and challenging area for exploration. Unfortunately, all the available biomarkers have many limitations to be prioritized for selection for diagnosis and follow up of pediatric sepsis.
One of the most promising biomarkers is pancreatic stone protein (PSP). Pancreatic stone protein (PSP) is encoded by a single transcript of the reg gene, resulting in a 144-amino acid length glycoprotein.
PSP is secreted mainly by pancreatic acinar cells as a component of the pancreatic juice. Besides, specific cells in stomach and intestine appeared to be secreting pancreatic stone protein.
This prospective cohort study was conducted to evaluate the value of pancreatic stone protein as a biomarker for detection of severity of critical illness and ability to differentiate between several groups of pediatric critical illness like SIRS, pediatric sepsis and severe sepsis. The study was conducted from August 2020 to May 2021.
This study was conducted on 75 patients admitted into PICU of Menoufia University Hospital and 15 apparently healthy controls from August 2020 to May 2021. Critically ill children admitted into the PICU who met the inclusion criteria were included in the study. Their age ranged from 1 month to 18 years old with 34 males and 41 females for the patient group and with 7 males and 8 females for the control group. Both groups were age and sex matched.
All included children were subjected to the following: Full history taking, general examination, Local examination and laboratory investigations. Mortality predictive scores were calculated to all patients on PICU admission which included the PRISM score, PIM II score and pSOFA score.
Serum PSP level was found to be significantly higher among children with critical illness than controls.
Besides, patients with sepsis or severe sepsis had significantly higher serum PSP level than patients with non-infectious SIRS or healthy controls.
Furthermore, we found that patients with severe sepsis had significant increase in serum PSP level than patients with sepsis.
Significant positive correlation was found between serum PSP level and CRP. Significant positive correlation was found between serum PSP level and serum total bilirubin. Significant negative correlation was found between serum PSP level and serum total calcium.
PSP had a good AUC (0.87) for discrimination between patients and controls.
Summary
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Above a cutoff of 11.03, PSP had a sensitivity of 86.67% and a specificity of 80%.
No significance of serum PSP level was found between survivors and non-survivors.