The Correlations of Human Atrial Natriuretic Peptide on Cardiac Function and Hemodynamics in Pediatric Septic Shock

Setyaningtyas, Arina; Soetjipto, Soetjipto; Endaryanto, Anang; Pudjiadi, Antonius Hocky

doi:10.2147/oaem.s379543

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…From the hemodynamic parameters in this study, cardiac power was lowest at initial resuscitation and then increased progressively at 1, 6, and 24 h post-initial resuscitation. The cardiac power recorded in our study was similar to previous findings in children with septic shock, which showed an increased trend during the first three days after resuscitation [ 15 ]. The result reflected the typical clinical course of shock after initial resuscitation, where CO and MAP were optimized through fluids, vasoactive, and inotropic drugs [ 11 ].…”

Section: Discussionsupporting

confidence: 90%

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The role of cardiac power and lactate clearance as an indicator of resuscitation success among pediatric patients with shock in the intensive care unit of Cipto Mangunkusumo Hospital

et al. 2023

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Background Shock in children remains the primary cause of mortality and morbidity worldwide. Furthermore, its management outcome is improved using many hemodynamic parameters, such as cardiac power (CP) and lactate clearance (LC). Cardiac power is a contractility index based on the measurement of flow and pressure, and it is a relatively new hemodynamic parameter with limited studies. In contrast, LC has been proven useful as a target outcome in shock resuscitation. This study aims to explore the values of CP and LC in pediatric shock and their association with clinical outcomes. Methods This prospective observational study was conducted on children (1 month-18 years old) with shock at Cipto Mangunkusumo Hospital, Indonesia, from April to October 2021. We measured CP using ultrasonic cardiac output monitoring (USCOM®) and serum lactate levels at 0, 1, 6, and 24 h post-initial resuscitation. Subsequently, the variables were described and analyzed with the resuscitation success, length of stay, and mortality. Results A total of 44 children were analyzed. There were 27 (61.4%), 7 (15.9%), 4 (9.1%), 4 (9.1%), and 2 (4.5%) cases of septic, hypovolemic, cardiogenic, distributive, and obstructive shock, respectively. Within the first 24 h post-initial resuscitation, CP and LC had an increasing trend. Compared to children who had successful resuscitation, those who did not have successful resuscitation had similar CP at all time points (p > 0.05) and lower LC at 1 and 24 h post-initial resuscitation (p < 0.05). Lactate clearance was an acceptable predictor of resuscitation success (area under the curve: 0.795 [95% CI: 0.660–0.931]). An LC of 7.5% had a sensitivity, specificity, positive predictive value, and negative predictive value of 75.00%, 87.5%, 96.43%, and 43.75%, respectively. Lactate clearance in the first hour post-initial resuscitation had a weak correlation (r=-0.362, p < 0.05) with hospital length of stay. We found no difference in CP and LC among survivors compared to nonsurvivors. Conclusions We found no evidence that CP was associated with resuscitation success, length of stay, or mortality. Meanwhile, higher LC was associated with successful resuscitation and shorter length of stay at the hospital, but not mortality.

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Section: Discussionsupporting

confidence: 90%

“…Based on previous studies in Indonesia, the proportion of septic shock was 51%, while the mean cardiac power and lactate clearance in children with septic shock on day 1 were 0.38 ± 0.35 and 44.17 ± 24.28%, respectively [ 4 , 15 , 16 ]. Therefore, with α of 5% and a margin of error of 15%, the sample size would be 44 children.…”

Section: Methodsmentioning

confidence: 99%

The role of cardiac power and lactate clearance as an indicator of resuscitation success among pediatric patients with shock in the intensive care unit of Cipto Mangunkusumo Hospital

et al. 2023

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“…54 Higher pro-ANP levels, which could result from lower levels of CORIN, are associated with poor survival prognosis in children and adults with severe sepsis and septic shock. 55,56 The lower levels of CORIN we observed could therefore result in higher levels of pro-ANP and lower levels of ANP, which could contribute to the hypertension, inflammation and cardiac manifestations associated with severity and shock in MIS-C. Future studies to measure the ratio of pro-ANP to ANP levels in MIS-C could provide insight into the disease mechanisms and help in validating our findings. While the best performing diagnostic biomarkers (PCSK9, CD163 and CXCL9) were significantly elevated in MIS-C patients, they were not found to be associated with severity of MIS-C.…”

Section: Discussionmentioning

confidence: 68%

Plasma Protein Biomarkers Distinguish Multisystem Inflammatory Syndrome in Children From Other Pediatric Infectious and Inflammatory Diseases

Yeoh,

Estrada-Rivadeneyra,

Jackson

et al. 2024

Pediatric Infectious Disease Journal

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Background: Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious hyperinflammatory complication following infection with severe acute respiratory syndrome coronavirus 2. The mechanisms underpinning the pathophysiology of MIS-C are poorly understood. Moreover, clinically distinguishing MIS-C from other childhood infectious and inflammatory conditions, such as Kawasaki disease or severe bacterial and viral infections, is challenging due to overlapping clinical and laboratory features. We aimed to determine a set of plasma protein biomarkers that could discriminate MIS-C from those other diseases. Methods: Seven candidate protein biomarkers for MIS-C were selected based on literature and from whole blood RNA sequencing data from patients with MIS-C and other diseases. Plasma concentrations of ARG1, CCL20, CD163, CORIN, CXCL9, PCSK9 and ADAMTS2 were quantified in MIS-C (n = 22), Kawasaki disease (n = 23), definite bacterial (n = 28) and viral (n = 27) disease and healthy controls (n = 8). Logistic regression models were used to determine the discriminatory ability of individual proteins and protein combinations to identify MIS-C and association with severity of illness. Results: Plasma levels of CD163, CXCL9 and PCSK9 were significantly elevated in MIS-C with a combined area under the receiver operating characteristic curve of 85.7% (95% confidence interval: 76.6%–94.8%) for discriminating MIS-C from other childhood diseases. Lower ARG1 and CORIN plasma levels were significantly associated with severe MIS-C cases requiring inotropes, pediatric intensive care unit admission or with shock. Conclusion: Our findings demonstrate the feasibility of a host protein biomarker signature for MIS-C and may provide new insight into its pathophysiology.

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“…Most of the patients in this study showed normal cardiac output (CO). Together with blood pressure, CO determines the prognosis of some critical illnesses and becomes a significant component in the diagnosis of cardiogenic shock (14). As mentioned in the previous parts, CO is the product of SV and HR.…”

Section: Discussionmentioning

confidence: 95%

Hemodynamic Profile of Pediatric Patients Admitted to Pediatric Intensive Care Unit Dr. Soetomo General Hospital

Aldora¹,

Setyaningtyas²,

Andriyanto³

et al. 2022

IJRP

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Background: Shock is one of the most commonly found conditions and causes high mortality rates in PICU. Macrocirculation and microcirculation hemodynamic monitoring is performed to know the degree of severity of the shock, to determine the treatment to be given, and to evaluate the previous treatments given. Objective: This study aims to determine the hemodynamic disturbances profile of pediatric patients in PICU of Dr. Soetomo General Hospital Surabaya in the period of 1 st September 2021-31 st May 2022. Methods: This study was an observational cross-sectional study. The data obtained were processed and analyzed using Microsoft Excel. Results: A total of 32 samples met the inclusion and exclusion criteria. The majority of the patients in this study (84,38%) suffered from septic shock. The macro-circulation hemodynamic measurements, the majority of the patients had normal blood pressure (53,13%), inadequate stroke volume (75%), tachycardia (78,13%), normal cardiac output (59,38%), normal SVR (68,75%), and inadequate DO2 (53,13%). In the microcirculation hemodynamic measurement, the majority of the patients had alactatemia (65,63%). Conclusion: The measurements of several hemodynamic parameters in majority of the pediatric shock patients showed the abnormality related to the shock condition, whereas the other parameters were in their normal ranges as the result of the early resuscitations given before the PICU administrations.

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The Correlations of Human Atrial Natriuretic Peptide on Cardiac Function and Hemodynamics in Pediatric Septic Shock

Cited by 5 publications

References 21 publications

The role of cardiac power and lactate clearance as an indicator of resuscitation success among pediatric patients with shock in the intensive care unit of Cipto Mangunkusumo Hospital

The role of cardiac power and lactate clearance as an indicator of resuscitation success among pediatric patients with shock in the intensive care unit of Cipto Mangunkusumo Hospital

Plasma Protein Biomarkers Distinguish Multisystem Inflammatory Syndrome in Children From Other Pediatric Infectious and Inflammatory Diseases

Hemodynamic Profile of Pediatric Patients Admitted to Pediatric Intensive Care Unit Dr. Soetomo General Hospital

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