Adrenomedullin is a useful biomarker for the prognosis of critically ill septic children.
OBJECTIVE
To measure midregional pro-adrenomedullin (MR-pro-ADM) in critically ill septic patients to determine its prognostic usefulness as compared with other used biomarkers in pediatric intensive care units, C-reactive protein (CRP) and procalcitonin (PCT).


METHODS
Prospective observational study conducted on 95 patients.


RESULTS
Mean levels of MR-pro-ADM were significantly higher when patients needed mechanical ventilation (3.2 ± 4.3 vs 1.6 ± 2.4) and inotropes (4.4 ± 5.2 vs 1.3 ± 1.2). Receiver operating characteristic curves of mortality were higher for MR-pro-ADM (cut-off value of 2.2). This marker showed higher positive predictive prognostic value than PCT and CRP (31 vs 21.6% and 15.8%, respectively).


CONCLUSIONS
MR-pro-ADM levels are good indicators of disease severity and show better reliability than PCT and CRP for predicting in-hospital mortality.
Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona, Spain.
Iolanda
I
Jordan
Patricia
P
Corniero
Mònica
M
Balaguer
Jessica
J
Ortiz
David
D
Vila
Jesús
J
Velasco
Francisco J
FJ
Cambra
Elisabeth
E
Esteban
D000293:Adolescent; D053607:Adrenomedullin / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D018572:Disease-Free Survival; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate
D053607:Adrenomedullin
C-reactive protein; adrenomedullin; diagnostic; procalcitonin; sepsis