الفهرس 
Sepsis overviewOnly 14 pages are availabe for public view
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Abstract
Pediatric sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Unfortunately, 51 - 75% of pediatric sepsis deaths occur within 48 hours of PICU admission.
In spite of the tremendous bad effect of pediatric sepsis on our patients, timely diagnosis is not that easy and even sometimes may be done according to clinical experience or data gathered from adult sepsis. Thus, rapid and accurate diagnosis and consequently appropriate treatment can be delayed making the issue more problematic.
Biomarkers for sepsis are a wide field of research, yet there are very limited studies in pediatrics in comparison with adults or even neonates. Generally, it is very promising and challenging area for exploration. Unfortunately, all the available biomarkers have many limitations to be prioritized for selection for diagnosis and follow up of pediatric sepsis.
One of the most important biomarkers is serum lactate to albumin ratio (LAR); Lactic acid is the terminal state of the anaerobic disintegration of glucose or carbohydrate metabolism in tissues. The normal serum lactate level is (4.5 - 20 mg/dl). Serum lactate concentration is a commonly used biomarker. Many studies have reported that hyperlactatemia is an independent predictor of mortality in critically ill patients.
Serum Albumin is secreted by the liver and plays a role in producing plasma colloid osmotic pressure.
In contrast to lactate, hypoalbuminemia is associated with an increased risk of mortality and can serve as a prognostic biomarker in patients with severe sepsis.
More recently, it was reported that the combination of lactate and albumin is a better predictor of mortality in septic and critically ill patients.
This prospective cohort study was conducted to evaluate the value of lactate to albumin ratio (LAR) and shock index as a biomarker for detection of severity of critical illness and ability to differentiate between several groups of pediatric critical illness like pediatric sepsis, severe sepsis and septic shock. The study was conducted from May 2022 to May 2023.
This study was conducted on 90 patients admitted into pediatric department (ward or PICU) of Menoufia University Hospital from May 2022 to May 2023. Critically ill children admitted into the PICU who met the inclusion criteria were included in the study. Their age ranged from 1 month to 18 years old.
All included children were subjected to the following: Full history taking, general examination, Local examination and laboratory investigations. Mortality predictive scores were calculated to all patients on PICU admission which included the PRISM score and pSOFA score.
Serum LAR appeared to be a good predictor of mortality among critically ill children and can differentiate between categories of sepsis like sepsis, severe sepsis, septic shock. Furthermore, serum LAR discriminate between survivors and non-survivors.