scholarly journals Hexosylceramides and Glycerophosphatidylcholine GPC(36:1) Increase in Multi-Organ Dysfunction Syndrome Patients with Pediatric Intensive Care Unit Admission over 8-Day Hospitalization

2021 ◽  
Vol 11 (5) ◽  
pp. 339
Author(s):  
Mara Leimanis-Laurens ◽  
Emily Wolfrum ◽  
Karen Ferguson ◽  
Jocelyn R. Grunwell ◽  
Dominic Sanfilippo ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Organ Dysfunction ◽  
Plasma Lipid ◽  
Pediatric Intensive Care ◽  
P Value ◽  
Time Points ◽  
Multi Organ Dysfunction Syndrome

Glycero- and sphingo-lipids are important in plasma membrane structure, caloric storage and signaling. An un-targeted lipidomics approach for a cohort of critically ill pediatric intensive care unit (PICU) patients undergoing multi-organ dysfunction syndrome (MODS) was compared to sedation controls. After IRB approval, patients meeting the criteria for MODS were screened, consented (n = 24), and blood samples were collected from the PICU at HDVCH, Michigan; eight patients needed veno-arterial extracorporeal membrane oxygenation (VA ECMO). Sedation controls were presenting for routine sedation (n = 4). Plasma lipid profiles were determined by nano-electrospray (nESI) direct infusion high resolution/accurate mass spectrometry (MS) and tandem mass spectrometry (MS/MS). Biostatistics analysis was performed using R v 3.6.0. Sixty-one patient samples over three time points revealed a ceramide metabolite, hexosylceramide (Hex-Cer) was high across all time points (mean 1.63–3.19%; vs. controls 0.22%). Fourteen species statistically differentiated from sedation controls (p-value ≤ 0.05); sphingomyelin (SM) [SM(d18:1/23:0), SM(d18:1/22:0), SM(d18:1/23:1), SM(d18:1/21:0), SM(d18:1/24:0)]; and glycerophosphotidylcholine (GPC) [GPC(36:01), GPC(18:00), GPC(O:34:02), GPC(18:02), GPC(38:05), GPC(O:34:03), GPC(16:00), GPC(40:05), GPC(O:36:03)]. Hex-Cer has been shown to be involved in viral infection and may be at play during acute illness. GPC(36:01) was elevated in all MODS patients at all time points and is associated with inflammation and brain injury.

scholarly journals Hexosylceramides and glycerophosphatidylcholine GPC(36:1) increase in Multi-Organ Dysfunction Syndrome patients with Pediatric Intensive Care Unit Admission over 8-day hospitalization

2021 ◽  
Author(s):  
Mara L. Leimanis-Laurens ◽  
Emily Wolfrum ◽  
Karen Ferguson ◽  
Jocelyn R. Grunwell ◽  
Dominic Sanfilippo ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Organ Dysfunction ◽  
Plasma Lipid ◽  
Pediatric Intensive Care ◽  
P Value ◽  
Time Points ◽  
Multi Organ Dysfunction Syndrome

AbstractGlycero- and sphingo-lipids are important in plasma membrane structure, caloric storage and signaling. An un-targeted lipidomics approach for a cohort of critically ill pediatric intensive care unit (PICU) patients, undergoing multi-organ dysfunction syndrome (MODS) was compared to sedation controls. After IRB approval, patients meeting criteria for MODS were screened, consented (n=24), and blood samples were collected from the PICU at HDVCH, Michigan; eight patients needed veno-arterial extracorporeal membrane oxygenation (VA ECMO). Sedation controls were presenting for routine sedation (n=4). Plasma lipid profiles were determined by nano-electrospray (nESI) direct infusion high resolution/accurate mass spectrometry (MS) and tandem mass spectrometry (MS/MS). Biostatistics analysis was performed using R v 3.6.0. 61 patient samples over 3 time points revealed a ceramide metabolite, hexosylceramide (Hex-Cer) was high across all time points (mean 1.63% - 3.19%; vs. controls 0.22%). Fourteen species statistically differentiated from sedation controls (P-value ≤0.05); sphingomyelin (SM) [SM(d18:1/23:0), SM(d18:1/22:0), SM(d18:1/23:1), SM(d18:1/21:0), SM(d18:1/24:0)]; and glycerophosphotidylcholine (GPC) [GPC(36:01), GPC(18:00), GPC(O:34:02), GPC(18:02), GPC(38:05), GPC(O:34:03), GPC(16:00), GPC(40:05), GPC(O:36:03)]. Hex-Cer has been shown to be involved in viral infection and may be at play during acute illness. GPC(36:01) was elevated in all MODS patients at all time points and is associated with inflammation and brain injury.

scholarly journals Pediatric Multi-Organ Dysfunction Syndrome: Analysis by an Untargeted “Shotgun” Lipidomic Approach Reveals Low-Abundance Plasma Phospholipids and Dynamic Recovery over 8-Day Period, a Single-Center Observational Study

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 774
Author(s):  
Mara L. Leimanis-Laurens ◽  
Karen Ferguson ◽  
Emily Wolfrum ◽  
Brian Boville ◽  
Dominic Sanfilippo ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Intensive Care ◽  
Critically Ill ◽  
Organ Dysfunction ◽  
Lipid Profiles ◽  
Critically Ill Children ◽  
P Value ◽  
Time Points ◽  
Logistic Organ Dysfunction ◽  
Multi Organ Dysfunction Syndrome

Lipids are molecules involved in metabolism and inflammation. This study investigates the plasma lipidome for markers of severity and nutritional status in critically ill children. Children with multi-organ dysfunction syndrome (MODS) (n = 24) are analyzed at three time-points and cross-referenced to sedation controls (n = 4) for a total of N = 28. Eight of the patients with MODS, needed veno-arterial extracorporeal membrane oxygenation (VA ECMO) support to survive. Blood plasma lipid profiles are quantified by nano-electrospray (nESI), direct infusion high resolution/accurate mass spectrometry (MS), and tandem mass spectrometry (MS/MS), and compared to nutritional profiles and pediatric logistic organ dysfunction (PELOD) scores. Our results show that PELOD scores were not significantly different between MODS and ECMO cases across time-points (p = 0.66). Lipid profiling provides stratification between sedation controls and all MODS patients for total lysophosphatidylserine (lysoPS) (p-value = 0.004), total phosphatidylserine (PS) (p-value = 0.015), and total ether-linked phosphatidylethanolamine (ether-PE) (p-value = 0.03) after adjusting for sex and age. Nutrition intake over time did not correlate with changes in lipid profiles, as measured by caloric and protein intake. Lipid measurement in the intensive care environment shows dynamic changes over an 8-day pediatric intensive care unit (PICU) course, suggesting novel metabolic indicators for defining critically ill children.

scholarly journals Respiratory Modalities in Preventing Reintubation in a Pediatric Intensive Care Unit

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199153
Author(s):  
Ameer Al-Hadidi ◽  
Morta Lapkus ◽  
Patrick Karabon ◽  
Begum Akay ◽  
Paras Khandhar
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Noninvasive Positive Pressure Ventilation ◽  
Pediatric Intensive Care ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
Positive Pressure ◽  
P Value

Post-extubation respiratory failure requiring reintubation in a Pediatric Intensive Care Unit (PICU) results in significant morbidity. Data in the pediatric population comparing various therapeutic respiratory modalities for avoiding reintubation is lacking. Our objective was to compare therapeutic respiratory modalities following extubation from mechanical ventilation. About 491 children admitted to a single-center PICU requiring mechanical ventilation from January 2010 through December 2017 were retrospectively reviewed. Therapeutic respiratory support assisted in avoiding reintubation in the majority of patients initially extubated to room air or nasal cannula with high-flow nasal cannula (80%) or noninvasive positive pressure ventilation (100%). Patients requiring therapeutic respiratory support had longer PICU LOS (10.92 vs 6.91 days, P-value = .0357) and hospital LOS (16.43 vs 10.20 days, P-value = .0250). Therapeutic respiratory support following extubation can assist in avoiding reintubation. Those who required therapeutic respiratory support experienced a significantly longer PICU and hospital LOS. Further prospective clinical trials are warranted.

scholarly journals Profil Pasien Sakit Kritis yang Dirawat di Pediatric Intensive Care Unit Rumah Sakit Cipto Mangunkusumo berdasar Sistem Skoring Pediatric Logistic Organ Dysfunction-2

Sari Pediatri ◽  
2019 ◽  
Vol 21 (1) ◽  
pp. 37
Author(s):  
Rismala Dewi ◽  
Fatimatuzzuhroh Fatimatuzzuhroh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Organ Dysfunction ◽  
Pediatric Intensive Care ◽  
Logistic Organ Dysfunction

Latar belakang. Skor PELOD-2 digunakan untuk mengetahui disfungsi organ pada anak dengan sakit kritis. Hasil skor PELOD-2 tidak selalu berbanding lurus dengan luaran perawatan anak sakit kritis sehingga tidak selalu dapat digunakan sebagai prediktor luaran dan mortalitas anak yang dirawat di PICU.Tujuan. Mengetahui profil dan luaran pasien sakit kritis yang dirawat berdasar skor PELOD-2.Metode. Penelitian dilakukan secara retrospektif dengan mengambil data rekam medis pasien rawat di ruang intensif anak RSUPN Cipto Mangukusumo, sejak Januari sampai Desember 2018. Pengambilan subjek secara total sampling, penilaian dilakukan pada 24 jam pertama perawatan. Hasil. Diperoleh 477 subjek yang memenuhi kriteria. Subjek sebagian besar berjenis kelamin laki-laki (56,4%), berusia <1 tahun (27,9%), dengan bedah sebagai diagnosis awal terbanyak (65%). Sebagian besar pasien memiliki penyakit kronik (70,4%). Angka mortalitas penelitian ini adalah 10,7%. Mayoritas subjek memiliki lama rawat <7 hari (75,5%). Subjek dengan lama rawat >14 hari memiliki median skor PELOD-2 tiga kali lipat dari subjek dengan lama rawat <7 hari. Titik potong luaran mortalitas skor PELOD-2 pada penelitian ini adalah >5, memiliki spesifisitas 84,5% dan sensitifitas 84,3% dengan nilai AUC skor PELOD-2 dari kurva ROC sebesar 93,4% (IK 95% 90,6–96,2).Kesimpulan. Skor PELOD-2 dapat digunakan untuk memprediksi disfungsi organ yang mengancam kehidupan pada anak tanpa imunosupresi dan semakin tinggi skor PELOD-2 akan diikuti dengan peningkatan lama rawat dan mortalitas.

scholarly journals Mean difference of Electrolyte Level measured in Arterial Blood gases and measured in Laboratory in Children presenting in Pediatric Intensive Care Unit

2021 ◽  
pp. 3-6
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Blood Gases ◽  
P Value ◽  
Arterial Blood Gases ◽  
K Value ◽  
Electrolyte Level ◽  
Arterial Blood

Background: Electrolytes are measured in arterial and venous blood by arterial blood gas analyzer and the auto-analyzers respectively. Objective: To determine the mean difference in electrolyte level in arterial blood gases (ABGs) level versus laboratory serum electrolyte level in the children admitted in the pediatric intensive care unit. Methodology: This cross-sectional study was conducted at department of Pediatrics, the Children’s Hospital and Institute of Child Health, Lahore from 1st December 2015 to 31st May 2016. Total of 125 children fulfilling inclusion criteria were enrolled in the study from pediatric intensive care unit. The ABGs (whole blood) electrolytes were obtained immediately after collection, using ABGs analyzer. Serum electrolytes were analyzed in the central laboratory of the institution. Reports were assessed and levels of sodium and potassium was noted from reports of ABGs and laboratory. Results: Mean NA+ value on ABGs and from laboratory was 134.66 and 132.26 (p= 0.01). Mean K+ value from on ABGs and from laboratory was 4.51 and 4.28. (p= 0.071). In age group 1-5 and 6-10 years, K+ level was high in ABGs value (p-value=0.065 & p-value=0.073). However, in age group 11-15 years K+ level was significantly higher in ABGs value as that of laboratory value (p-value=0.014). The same trend was observed in male and female children that mean NA+ and K+ value with ABGs was significantly higher as compared to that of laboratory value. Conclusion: NA+ and K+ in arterial blood gases level were different from laboratory serum electrolyte level in children admitted to pediatric intensive care unit. Clinician should be aware of differences so that potential misdiagnosis does not occur and unnecessary treatment or investigation can’t be performed.

scholarly journals Faktor yang Berhubungan dengan Hiperglikemia dan Luarannya pada Anak Sakit Kritis

Sari Pediatri ◽  
2016 ◽  
Vol 15 (1) ◽  
pp. 32
Author(s):  
Rosary Rosary ◽  
Imral Chair ◽  
Pustika Amalia ◽  
Agus Firmansyah ◽  
Irawan Mangunatmadja ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Organ Dysfunction ◽  
Pediatric Intensive Care ◽  
Logistic Organ Dysfunction

Latar belakang. Hiperglikemia pada sakit kritis berhubungan dengan luaran yang lebih buruk, seperti lama penggunaan ventilasi mekanik, dan obat vasoaktif lebih panjang, serta derajat disfungsi organ yang lebih berat.Tujuan. Mengetahui hubungan karakteristik subjek dengan hiperglikemia serta mengetahui perbedaan proporsi subjek yang mengalami hiperglikemia antara kelompok subjek yang memakai ventilasi mekanik, mendapat obat vasoaktif, serta dengan disfungsi organ berat, dibandingkan dengan kelompok subjek yang tidak.Metode. Studi analitik potong lintang dilakukan pada anak sakit kritis di Pediatric Intensive Care Unit (PICU) Rumah Sakit Cipto Mangunkusumo (RSCM) usia 1 bulan-18 tahun, dilakukan antara Maret-Juni 2011.Hasil. Didapatkan 87 subjek penelitian, 60 di antaranya laki-laki. Hiperglikemia ditemukan pada 25/87 (28,7%) subjek dengan median kadar glukosa darah 121 (37-443) mg/dL Hiperglikemia ditemukan lebih banyak pada laki-laki, usia >1-5 tahun, gizi kurang, dan pasca-bedah, tetapi tidak ditemukan hubungan yang bermakna. Subjek yang menggunakan ventilasi mekanik dan vasoaktif memiliki proporsi lebih besar mengalami hiperglikemia dibandingkan dengan subjek yang tidak, tetapi perbedaan ini juga tidak bermakna. Enam dari 10 subjek yang memiliki skor Pediatric Logistic Organ Dysfunction (PELOD) tinggi mengalami hiperglikemia. Proporsi ini lebih besar dibandingkan subjek dengan skor PELOD rendah, yaitu 19/77 subjek (p=0,03).Kesimpulan. Proporsi subjek yang mengalami hiperglikemia lebih besar pada anak dengan disfungsi organ berat daripada disfungsi organ ringan. Karakteristik subjek tidak berhubungan dengan hiperglikemia pada sakit kritis. Tidak terbukti adanya perbedaan proporsi subjek yang mengalami hiperglikemia pada anak sakit kritis yang menggunakan ventilasi mekanik dan obat vasoaktif dibandingkan dengan kelompok subjek yang tidak.

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