Pro-adrenomedullin usefulness in the management of children with community-acquired pneumonia, a preliminar prospective observational study

BMC Research Notes

Carles Luaces Cubells²  Jesús Velasco Rodríguez¹  Gemma Claret Teruel²  Susanna Hernández-Bou²  Joan Calzada Hernández²  Marta Sardà Sánchez² 

[1] Laboratory Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain;Emergency Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain

关键词: Children;    Pneumonia;    Pro-adrenomedullin;   

Others  :  1166127
DOI  :  10.1186/1756-0500-5-363

 received in 2012-05-02, accepted in 2012-07-02,  发布年份 2012

【 摘 要 】

Background

In adult population with community acquired pneumonia high levels of pro-adrenomedullin (pro-ADM) have been shown to be predictors of worse prognosis. The role of this biomarker in pediatric patients had not been analyzed to date. The objective of this study is to know the levels of pro-ADM in children with community acquired pneumonia (CAP) and analyze the relation between these levels and the patients’ prognosis.

Findings

Prospective observational study including patients attended in the emergency service (January to October 2009) admitted to hospital with CAP and no complications at admission. The values for pro-ADM were analyzed in relation to: need for oxygen therapy, duration of oxygen therapy, fever and antibiotic therapy, complications, admission to the intensive care unit, and length of hospital stay. Fifty patients were included. Ten presented complications (7 pleural effusion). The median level of pro-ADM was 1.0065 nmol/L (range 0.3715 to 7.2840 nmol/L). The patients presenting complications had higher levels of pro-ADM (2.3190 vs. 1.1758 nmol/L, p = 0.013). Specifically, the presence of pleural effusion was associated with higher levels of pro-ADM (2.9440 vs. 1.1373 nmol/L, p < 0.001).

Conclusions

In our sample of patients admitted to hospital with CAP, pro-ADM levels are related to the development of complications during hospitalization.

【 授权许可】

   
2012 Sardà Sánchez et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1 .

【 参考文献 】

• [1]Querol-Ribelles JM, Tenías JM, Querol-Borrás JM, González-Granda D, Hernández M, Ferreruela R, Martínez I, Grupo NAC 2000: Validation of the Pneumonia Severity Index for hospitalizing patients with community-acquired pneumonia. Med Clin 2004, 122:481-486.
• [2]Bauer TT, Ewig S, Marre R, Suttorp N, Welte T, CAPNETZ Study Group: CRB-65 predicts death from community-acquired pneumonia. J Intern Med 2006, 260:93-101.
• [3]Almirall J, Bolibar I, Toran P, Pera G, Boquet X, Balanzo X, Sauca G, Community-Acquired Pneumonia Maresme Study Group: Contribution of C-reactive protein to the diagnosis and assessment of severity of community-acquired pneumonia. Chest 2004, 125:1335-1342.
• [4]Masiá M, Gutiérrez F, Shum C, Padilla S, Navarro JC, Flores E, Hernández I: Usefulness of procalcitonin levels in community-acquired pneumonia according to the patients outcome research team pneumonia severity index. Chest 2005, 128:2223-2229.
• [5]Yende S, Tuomanen EI, Wunderink R, Kanaya A, Newman AB, Harris T, de Rekeneire N, Kritchevsky SB: Preinfection systemic inflammatory markers and risk of hospitalization due to pneumonia. Am J Respir Crit Care Med 2005, 172:1440-1446.
• [6]Christ-Crain M, Morgenthaler NG, Stolz D, Muller C, Bingisser R, Harbarth S, Tamm M, Struck J, Bergmann A, Müller B: Proadrenomedullin to predict severity and outcome in community-acquired pneumonia. Crit Care 2006, 10:R96. BioMed Central Full Text
• [7]Huang DT, Angus DC, Kellum JA, Pugh NA, Weissfeld LA, Struck J, Delude RL, Rosengart MR, Yealy DM: Midregional proadrenomedullin as a prognostic tool in community-acquired pneumonia. Chest 2009, 136:823-831.
• [8]Christ-Crain M, Morgenthaler NG, Struck J, Harbarth S, Bergmann A, Muller B: Mid-regional pro-adrenomedullin as a prognostic marker in sepsis: an observational study. Crit Care 2005, 9:R816-824. BioMed Central Full Text
• [9]Gegenhuber A, Struck J, Dieplinger B, Poelz W, Pacher R, Morgenthaler NG, Bergmann A, Haltmayer M, Mueller T: Comparative evaluation of B-type natriuretic peptide, mid-regional pro-Atype natriuretic peptide, mid-regional pro-adrenomedullin, and Copeptin to predict 1-year mortality in patients with acute destabilized heart failure. J Card Fail 2007, 13:42-49.
• [10]Hirata Y, Mitaka C, Sato K, Nagura T, Tsunoda Y, Amaha K, Marumo F: Increased circulating adrenomedullin, a novel vasodilatory peptide, in sepsis. J Clin Endocrinol Metab 1996, 81:1449-1453.
• [11]Albrich WC, Dusemund F, Rüegger K, Christ-Crain M, Zimmerli W, Bregenzer T, Irani S, Buergi U, Reutlinger B, Mueller B, Schuetz P: Enhanced of CURB65 score with proadrenomedullin (CURB65-A) for outcome prediction in lower respiratory tract infections: Derivation of a clinical algorithm. BMC Infect Dis 2011, 11:112. BioMed Central Full Text
• [12]Bello S, Lasierra AB, Mincholé E, Fandos S, Ruiz MA, Vera E, de Pablo F, Ferrer M, Menendez R, Torres A: Prognostic power of proadrenomedullin in community-acquired pneumonia is independent of aetiology. Eur Respir J 2012, 39:1144-1155.
• [13]Suberviola B, Castellanos-Ortega A, Llorca J, Ortiz F, Iglesias D, Prieto B: Prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumonia. Swiss Med Wkly 2012, 19(142):w13542.