Researchers from the University of Oviedo improve the diagnosis in children in critical condition
December 12, 2013
A research conducted at the pediatric CCUs of the Central University and Gregorio Marañón hospitals link the level of several bio-markers to the risk of mortality.
Achieving a fast and precise diagnosis is vital for cases of children who get to the hospital with a serious illness. Researchers from the University of Oviedo, the Central University Hospital of Asturias (HUCA) and the Gregorio Marañón Institute of Sanitary Research of Madrid have made progress in the process of validation in the clinical practice of certain bio-markers that alert of a greater risk of mortality in children in critical care. The tests conducted on 250 pediatric patients in critical state has allowed the researchers to demonstrate that the levels of each of these four markers allowed them to better establish the prognosis and mortality risk of these young patients.
The prestigious journal Critical Care has just published the conclusions of the research conducted during a year and a half in patients of the pediatric CCU of both hospital, coordinated by Corsino Rey, professor of the Department of Medicine of the University of Oviedo. The study has been conducted with the support of the Ernesto Sánchez Villares Foundation and Thermofisher-Brahms.
The possibility of detecting during the first hours of admission through these bio-markers is greatly useful to thoroughly monitor and intensely treat patients with a higher risk of mortality. The research has proved that the presence of high levels of certain markers in children in critical state warns of a higher risk of mortality. Doctors have centered their analysis in four bio-markers: procalcitonine, pro-adrenomeduline, pro-endoteline and reactive protein C.
A blood test during the first few hours after admission in the pediatric CCU helps in diagnosis the seriousness of the illness of these children.
Corsino Rey's team has been working for more than a decade in the analysis of procalcitonine as a marker to alert of the presence of an infection or a generalized swelling at the organism. The researchers from the University of Oviedo have pioneered the use of this molecule as a bio-marker to detect more easily the problems related to swelling or infections.
In the case of pro-adrenoduline and pro-endoteline, they both alert of the presence of some problem at the external cover of blood vessels. In turn, reactive protein C has been used for years as a marker of infections at the pediatric CCU.
The next step in the research will be to analyze the impact of the evolution of the levels of these markers in the process of improvement or worsening of the patients. Doctors establish a series of landmarks in the scale that allows them to determine the gravity of each case, which translates as a key advantage in the recovery of the patient and to properly communicate the relevant information to the families. The clinical experience at the pediatric CCUs of both hospitals has led to a monitoring of the evolution of the patients and the levels of each marker. This process is currently understood to show that if the markers decrease, the evolution will be positive, while if the markers increase, the prognosis worsens, although this interpretation must be verified in successive studies.
Authors of the Article
Rey C, García-Hernández I, Concha A, Martínez-Camblor P, Botrán M, Medina A, Prieto B, López-Herce J. Pro-adrenomedullin, pro-endothelin-1, procalcitonin, C-reactive protein and mortality risk in critically ill children: a prospective study. Crit Care. 2013 Oct 16;17(5):R240
- Corsino Rey (University of Oviedo and HUCA)
- Andrés Concha (HUCA)
- Alberto Medina (HUCA)
- Pablo Martínez-Camblor (University of Oviedo and FICYT)
- Francisco Álvarez (University of Oviedo and HUCA)
- Belén Prieto (HUCA)
- Yolanda Díaz (University of Oviedo and HUCA)
- Sergio Menéndez (HUCA)
- Irene García-Hernández (Juan Canalejo Hospital, La Coruña)
- Juan Mayordomo (San Agustín Hospital and HUCA)
- Marta Los Arcos (Valle del Nalón Hospital and HUCA)
- Ana Vivanco (HUCA)
- Reyes Fernández (HUCA)
Gregorio Marañón Sanitary Research Team of Madrid
- Jesús López-Herce
- Marta Botrán