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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Objective To evaluate validity of serum mannose-binding lectin (MBL) measurement in diagnosis and prognosis of sepsis among critically ill children. Background MBL is a part of the innate immune system with a potential role in sepsis susceptibility. Patients and methods A prospective observational study was conducted that included 50 critically ill children admitted into the pediatric intensive care unit. Another group of 38 healthy children served as a control group. Serum MBL level was measured for all patients (within 24 h) and controls. Patients were monitored till hospital discharge to determine the diagnosis of sepsis and occurrence of morbidity and mortality. Results No significant difference in MBL level was noted between septic patients and controls [median and range = 2.1 (1.2–298) vs. 2.25 (1.4–134); P = 0.45] or between survivors and nonsurvivors [median and range = 2.4 (1.1–298) vs. 10.95 (1.3–244); P = 0.75]. MBL had a significant negative correlation with C-reactive protein (rs=−0.33; P = 0.021) but not with pediatric risk of mortality, pediatric index of mortality 2, or sequential organ failure assessment score. MBL had a poor area under receiver operating characteristic (area under the curve) curve for prediction of mortality compared with pediatric risk of mortality, sequential organ failure assessment, and pediatric index of mortality 2 (area under the curve = 0.54, 0.91, 0.90, and 0.75, respectively). No significant correlation was found between MBL and length of pediatric intensive care unit stay or mechanical ventilation duration. Conclusion MBL is neither useful for sepsis diagnosis nor prediction of mortality or morbidity. The routinely available markers and prognostic scores are much more powerful compared with an expensive marker like MBL.

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