OBJECTIVETo study the correlation between serum procalcitonin (PCT) level and severity of infant muggy syndrome (IMS) and the predictive value of PCT in the development of multiple organ dysfunction syndrome (MODS) in children with IMS.

METHODSFifty children with IMS were classified into two groups according to the presence of MODS: MODS (n=29) and non-MODS (n=21). According to a 30-day follow-up result, they were classified into survival (n=36) and deceased groups (n=14). Vital signs, routine biological measurements (arterial blood gas, blood routine, CRP, liver and kidney functions, myocardial enzyme and so on) and the disease severity evaluated by the Pediatric Critical Illness Score (PCIS) within 24 hours of admission were recorded. Serum levels were measured using the semi-quantitative PCT-Q test within 24 hours of admission.

RESULTSForty-seven children (94%) had elevated serum PCT levels (≥ 0.5 ng/mL) at admission. There were lower PCIS scores, higher rates of MODS and higher levels of serum PCT in deceased patients than survivors (P<0.05). There was a significant negative correlation between serum PCT levels and PCIS scores (r=-0.84, P<0.05). Serum PCT levels in the MODS group were significantly higher than in the non-MODS group (P<0.01). Receiver operating characteristic curve showed that, if the cut-off point of serum PCT level was 10.6 ng/mL, the sensitivity and specificity of PCT were 79.3% and 90.5% respectively, in predicting MODS, with the area under the curve of 0.924 ( P<0.01).

CONCLUSIONSSerum PCT level at admission is correlated with the severity of IMS and it may be an early predictive marker of MODS.

Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Multiple Organ Failure ; blood ; diagnosis ; etiology ; Protein Precursors ; blood ; Syndrome

Thrombocytopenia-associated multiple organ failure (TAMOF) has a high mortality rate when not treated, and early detection of TAMOF is very important diagnostically and therapeutically. We describe herein our experience of early detection of TAMOF, using an automated hematology analyzer. From 498,390 inpatients, we selected 12 patients suspected of having peripheral schistocytosis, based on the results of red blood cell (RBC) parameters and a volume/hemoglobin concentration (V/HC) cytogram. We promptly evaluated whether the individual patients had clinical manifestations and laboratory findings were consistent with TAMOF. Plasma exchanges were then performed for each patient. All 12 patients had TAMOF. The mean values of RBC parameters were significantly higher in all of the patients than with the reference range, however, 3 patients had % RBC fragments within the reference range. The mean value of ADAMTS-13 activity was slightly lower in patients compared with the reference range. Of the 12 patients, remission was obtained in 9 patients (75%) within 4 to 5 weeks using plasma exchanges. Three patients died. An increased percentage of microcytic hyperchromic cells with anisocytosis and anisochromia indicated the presence of schistocytes, making it an excellent screening marker for TAMOF. Identification of TAMOF with RBC parameters and a V/HC cytogram is a facile and rapid method along with an automated hematology analyzer already in use for routine complete blood cell counting test.
Adult ; Aged ; Aged, 80 and over ; Erythrocyte Indices ; Erythrocytes, Abnormal/pathology ; Female ; Hematologic Tests ; Hemoglobins/metabolism ; Humans ; Male ; Middle Aged ; Multiple Organ Failure/*blood/*diagnosis/etiology ; Thrombocytopenia/*blood/complications/*diagnosis

OBJECTIVETo evaluate the influence of glucose-insulin-potassium treatment (GIK) on the levels of inflammatory cytokines in the scalded rats with MODS.

METHODSOne hundred and twenty Sprague Dawley rats were inflicted with 30% TBSA full-thickness scalding, and MODS model was reproduced with intraperitoneal injection of endotoxin following burn injury. Then the rats were randomly divided into GIK, glucose (G) and control (C) groups, with 40 rats in each group. The serum contents of glucose, lactate acid, TNF-alpha, NO and IL-6 of the rats in the three groups were determined during 1 to 7 PSD, and the mortality rate within 7 PSD was observed.

RESULTSThe serum contents of glucose, lactate acid, TNF-alpha, NO and IL-6 of the rats in the GIK group were obviously lower than those in the other two groups during 1 to 7 PSD (P < 0.01), and reached the lowest level at 6 to 7 PSD (TNF-alpha: 2.37 +/- 0.54 microg/L; IL-6: 0.28 +/- 0.17 microg/L; NO: 29 +/- 9 micromol/L). The content of glucose and lactate acid in G group were obviously higher than those in control group (P < 0.01), but the contents of TNF-alpha, IL-6 and NO content were similar between these two groups (P > 0.05). The mortality in GIK group within 7 PSD was 20.0%, which was evidently lower than that in G (37.5%) and C (47.5%) groups (P < 0.05), while that between G and C groups was similar (P > 0.05).

CONCLUSIONThe administration of GIK might ameliorate sepsis by reducing the levels of inflammatory cytokine after burns and endotoxin challenge.

Animals ; Blood Glucose ; metabolism ; Burns ; complications ; diagnosis ; metabolism ; Cytokines ; metabolism ; Disease Models, Animal ; Glucose ; therapeutic use ; Insulin ; therapeutic use ; Lactic Acid ; blood ; Multiple Organ Failure ; diagnosis ; etiology ; metabolism ; Potassium ; therapeutic use ; Prognosis ; Rats ; Rats, Sprague-Dawley