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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Objective

Assessment the role of copeptin as a diagnostic and prognostic biomarker for sepsis in a pediatric intensive care unit (PICU).

Background

Copeptin has been proposed as a promising biomarker for the diagnosis and prognosis of pediatric sepsis in patients with systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock.

Patients and methods

This prospective case–control study was conducted on 75 patients with sepsis admitted to the PICU of Menoufia University Hospital and 25 healthy controls. All patients are subjected to a detailed history, physical examination, and laboratory investigations. Pediatric Sequential Organ Failure Assessment, Pediatric Risk of Mortality III (PRISM III), and Pediatric Index of Mortality II scores were measured in the first 24 h of admission. Copeptin level was measured by enzyme-linked immunosorbent assay. A single measurement of copeptin was done for all patients and the control group within 24 h of admission to the PICU.

Results

Copeptin was highly significantly increased in the patient group and subgroups than controls. Copeptin was highly significantly increased in the severe sepsis group than sepsis and systemic inflammatory response syndrome groups. Copeptin was highly significantly increased in nonsurvivors than survivors. There was a significant increase in nonsurvivors compared with survivors regarding ventilation, PRISM, Pediatric Index of Mortality II, and Pediatric Sequential Organ Failure Assessment scores. There were significant positive correlations between copeptin level and PICU stay, PRISM score, and PRISM risk mortality. The cutoff point of copeptin level was 2.34 ng/ml, which had a sensitivity of 96% and a specificity of 92% for the prediction of sepsis.

Conclusion

Copeptin is a useful diagnostic and prognostic biomarker in pediatric sepsis.

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