Clinical and pathologic characteristics of pancreatic necrosis in critically ill children

Zhu, Yimin; Liu, Fang; Zhou, Xiao-Yu; Gao, Xirong; Xu, Zhiyue; Yu-kai, DU

doi:10.5847/wjem.j.1920-8642.2011.02.006

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…In our previous study, we found that critically ill children (those with disseminated tuberculosis, fulminant hepatitis, and other severe infection) had their pancreas with inflammatory cells infiltration, hemorrhage, necrosis, and other organic damage. 22 Pancreatic pathological anatomy of 44 critically ill children after death showed that secondary pancreatic injury and inflammatory cells infiltration were observed among 61.4% of cases. 23 Insulin secretion is inhibited by inflammatory factors, such as TNF-α, and IL-1, in the process of the inflammatory response in vivo.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Beta Cell Dysfunction and Severity of Disease Among Critically Ill Children

Lu²,

Xiao³

et al. 2016

Medicine

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Although beta cell dysfunction has been proved to predict prognosis among humans and animals, its prediction on severity of disease remains unclear among children. The present study was aimed to examine the relationship between beta cell dysfunction and severity of disease among critically ill children.This prospective study included 1146 critically ill children, who were admitted to Pediatric Intensive Care Unit (PICU) of Hunan Children's Hospital from November 2011 to August 2013. Information on characteristics, laboratory tests, and prognostic outcomes was collected. Homeostasis model assessment (HOMA)-β, evaluating beta cell function, was used to divide all participants into 4 groups: HOMA-β = 100% (group I, n = 339), 80% ≤ HOMA-β < 100% (group II, n = 71), 40% ≤ HOMA-β < 80% (group III, n = 293), and HOMA-β < 40% (group IV, n = 443). Severity of disease was assessed using the worst Sequential Organ Failure Assessment (SOFA) score, Pediatric Risk of Mortality (PRISM) III score, incidence of organ damage, septic shock, multiple organ dysfunction syndrome (MODS), mechanical ventilation (MV) and mortality. Logistic regression analysis was used to evaluate the risk of developing poor outcomes among patients in different HOMA-β groups, with group I as the reference group.Among 1146 children, incidence of HOMA-β < 100% was 70.41%. C-peptide and insulin declined with the decrement of HOMA-β (P < 0.01). C-reactive protein and procalcitonin levels, rather than white blood cell, were significantly different among 4 groups (P < 0.01). In addition, the worst SOFA score and the worst PRISMIII score increased with declined HOMA-β. For example, the worst SOFA score in group I, II, III, and IV was 1.55 ± 1.85, 1.71 ± 1.93, 1.92 ± 1.63, and 2.18 ± 1.77, respectively. Furthermore, patients with declined HOMA-β had higher risk of developing septic shock, MODS, MV, and mortality, even after adjusting age, gender, myocardial injury, and lung injury. For instance, compared with group I, the multivariate-adjusted odds ratio (95% confidence interval) for developing septic shock was 2.17 (0.59, 8.02), 2.94 (2.18, 6.46), and 2.76 (1.18, 6.46) among patients in group II, III, and IV, respectively.Beta cell dysfunction reflected the severity of disease among critically ill children. Therefore, assessment of beta cell function is critically important to reduce incidence of adverse events in PICU.

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Section: Discussionmentioning

confidence: 99%

Relationship Between Beta Cell Dysfunction and Severity of Disease Among Critically Ill Children

Lu²,

Xiao³

et al. 2016

Medicine

Self Cite

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show abstract

“…Zhu et al noted that pancreatic damage or pancreatic necrosis in critically ill children is characterized by acute onset, profound severity, short course and multiple organ failure. It may be asymptomatic in early stage, and can be easily missed (Zhu et al, 2011).…”

Section: Acute Haemorrhagic Pancreatitismentioning

confidence: 99%