BACKGROUND: The burden of sepsis is global despite measures to improve its prompt recognition. However, there is no single reliable parameter for its early detection. Heparin-binding protein (HBP) is a new and promising biomarker for sepsis. Presently, there are no published reports in children apart from a limited study on UTI.

OBJECTIVE: To evaluate the role of HBP as a diagnostic tool and prognostic marker of sepsis syndrome among pediatric patients.

METHODS: This prospective cohort study enrolled pediatric patients who were categorized as SIRS or sepsis syndrome. HBP assay was determined on Day1. Likewise, blood culture was taken. A 7-day observation period using PELOD scoring was done. Final category as SIRS or sepsis syndrome was done on Day7. Statistical analysis was done to know relationship of HBP level to SIRS and sepsis.

RESULTS: 106 patients were included in this study. There was statistical significance in the correlation of HBP assay with presence of growth in blood culture and toxic granulations, length of ventilator support, and development of complications including mortality. The cutoff point was >125ng/mL. Sensitivity and specificity for HBP in sepsis syndrome were 98.31% and 97.87% respectively. Positive predictive value was 98.3%. Negative predictive value was 97.9%. Positive likelihood ratio was 46.2. Negative likelihood ratio was 0.017. Risk ratio was 47.6. Subjects with HBP level of >125 ng/mL had 47.6 times the risk of having sepsis syndrome as compared to those with level

CONCLUSION & RECOMMENDATIONS: Elevated HBP level is a useful diagnostic and prognostic marker for childhood sepsis syndrome. Determination of HBP levels at different time intervals within a longer observation period may give a more accurate description of subject's clinical improvement or progression to MODS or mortality.

Human ; Pediatrics ; Systemic Inflammatory Response Syndrome ; Sepsis

BACKGROUND: Painful procedures intensify hospital-related stress and anxiety leading to unpleasant experience that can adversely affect procedure outcomes and health seeking behaviors.

OBJECTIVE: To determine the effect of a cold vibrator device on pain perception of children aged 6-12 years old during Mantoux Test at the Out-Patient Department of the Philippine Children's Medical Center.

METHODOLOGY: This is a single blinded, randomized control trial where one-hundred four (104) subjects were randomly assigned to experimental (54 subjects) and control group (50 subjects) through fishbowl method. The experimental group received the cold vibrator prior to Mantoux test while the control group received the Mantoux test alone. Pre and post procedural heart rate, respiratory rate and oxygen saturation were obtained. The responses were evaluated using the Wong-Baker Faces Pain Scale.

RESULTS: Pain score was higher in the control group. Wilcoxon Rank-Sum Test showed mean rank of 67.5 with aggregated pain rank of 3645.00 compared to experimental group (with cold vibrator) of 36.3 with aggregated pain rank of 1815.00 with a p value 0.0000000046. There was no significant difference between the physiologic parameters (heart rate, respiratory rate, and oxygen saturation) before and after procedure between the two groups.

CONCLUSION AND RECOMMENDATION: The use of the cold vibrator was effective in reducing pain perception. It can be used as an adjunct to mitigate pain for needle-related procedures. Demographic data could also be correlated to the pain scores of the subjects. 

Human ; Male ; Female ; Pre-adolescent (a Child 6-12 Years Of Age) ; Pain ; Pain Perception