Albumin, a vital component in regulating human blood oncotic pressure, plays an important role in the prediction of prognosis in pediatric patients.Previous research identified significant differences in serum albumin levels of healthy and critically ill children. The present study aims to investigate the correlation between albumin levels measured during pediatric intensive care unit(PICU) admission and clinical outcomes. In 2022, a comprehensive analysis of the records was conducted retrospectively in four tertiary hospital PICUs in different cities in the south-east region of Turkey. We then conducted a ROC analysis to predict mortality based on hypoalbuminemia.A cut-off value was determined, and the patients were divided into two groups: hypoalbuminemic and normoalbuminemic.Based on this cut-off level, we evaluated the association between admission serum albumin levels and mortality, length of stay, laboratories, need for mechanical ventilation, and extracorporeal treatments. A total of 1329 patients admitted to the PICUs between January 1, 2022 and January 1, 2023 were included. The mortality rate amounted to 16.2%.The mean albumin level was 4.03 ± 0.69 g/dl in the surviving and 3.35 ± 0.90 g/dl in the non-surviving group(p < 0.001).The average length of stay in the PICU amounted to 8.98 ± 17.07, while the mean length of hospital stay was 11.23 ± 18.81days.Patients with hypoalbuminemia had significantly longer stays in the PICU and hospital as compared to those with normal albumin levels(p = 0.025 and p < 0.001,respectively).We found robust evidence that albumin levels are a strong predictor of mortality, with a predictive rate of 84.5%(OR:0.322, 95% CI:0.263–0.395, p < 0.001).The cut-off value was 3.785(AUC:0.731, Sensitivity:68.3%, Specificity:67%). A negative correlation was identified between albumin levels and lactate, C- reactive protein (CRP), and Blood urea nitrogen (BUN) levels across all patients. Conversely, a positive correlation was observed between neutrophil, lymphocyte, platelet, hemoglobin, sodium, and glucose levels. However, in patients with a cut-off point of 3.785 for albumin levels, a negative correlation was observed between albumin and lactate, CRP, and creatine levels. Conversely, a positive correlation was found between bicarbonate, platelet, hemoglobin, and glucose levels. Based on these findings, we conclude that hypoalbuminemia is associated with a higher rate of inotrope therapy and mechanical ventilation support. Furthermore, the rates of plasmapheresis, continuous renal replacement therapy, and extracorporeal membrane oxygenation initiation were markedly reduced in patients with elevated albumin levels (p < 0.001). The serum albumin, which is an excellent and cost-effective biomarker that can be readily and economically evaluated in any center worldwide, as evidenced by the findings of our study, is a highly efficacious indicator of admission albumin levels for the prediction of mortality and outcomes in PICUs. Furthermore, it predicts the selection of appropriate treatment and mechanical supports. It is straightforward to utilise, as it does not necessitate the use of scoring systems or tests that require lengthy and intricate analyses, and it is readily available.

Aim: To evaluate the lactate/albumin ratio and its relation to mortality in children with nosocomial infections. Materials & methods: One hundred six children were included in this study. Blood gas... Tweetable abstract The lactate/albumin ratio is a useful indicator for predicting mortality in children with nosocomial infections. This study finds that comparing values at 24 h may provide the be...

In children, community-acquired pneumonia (CAP) has a high mortality and morbidity rate. The purpose of our study is to determine the diagnostic value of complete blood parameters for CAP and to look into their relationship to disease severity and mortality. A retrospective, the cross-sectional study enrolled children aged 0–18 years who were diagnosed with CAP in the pediatric intensive care unit (PICU) between January 1, 2023 and December 31. The patients included in the study were divided into two groups according to their clinical severity: the moderate group (MG) receiving non-invasive ventilation (NIV) and the severe group (SG) receiving invasive ventilation (IMV) support. In addition to demographic analyses, a comprehensive battery of laboratory tests was conducted on all included patients, and the relationships between mortality and clinical severity were compared. Furthermore, the study also involved the comparison of various biological markers such as mean platelet volume (MPV), C-reactive protein (CRP), albumin, lactate, CRP/MPV, neutrophile/lymphocyte ratio (NLR), lactate/albumin ratio (L/A), and white blood cell (WBC)/MPV values between the two groups, along with an evaluation of their clinical implications.ü A total of 120 patients were included in the study, the mean age was 44.13 ± 53.03 months, and the mean PICU stay was 11.52 ± 19.75 days. Clinical severity assessment showed that 54 (45%) patients received NIV and 66 (55%) required IMV. Mortality was significantly associated with the type of infectious agent (p = 0.022), respiratory support type (p = 0.019), length of stay (LOS) (p = 0.014), lactate (p = 0.037), and L/A ratio (p = 0.022). ROC analysis revealed that the L/A ratio had a superior predictive value over lactate alone in mortality prediction. Significant differences between MG and SG were observed for LOS (p = 0.006), CRP (p = 0.019), CRP/MPV (p = 0.017), and L/A ratio (p = 0.047). Both CRP/MPV and L/A ratios were significantly higher in the IMV group (p = 0.017, p = 0.047). In the linear regression model, CRP/MPV and L/A ratio were associated with mortality (R²=0.189), with CRP/MPV being 1.1 times more effective in determining respiratory support (p = 0.037, accuracy: 56.7%). CRP/MPV showed a moderate positive correlation with L/A (r = 0.435, p < 0.001), while a weak positive correlation was found between NLR and WBC/MPV (r = 0.264, p = 0.004). No significant correlation was found between LOS and CRP/MPV, NLR, L/A, or WBC/MPV (p > 0.05). Mortality was significantly associated with infectious agent type, respiratory support type, LOS, lactate, and L/A ratio. CRP, CRP/MPV, and L/A ratio differed significantly between clinical severity groups. CRP/MPV may be useful in assessing mortality, clinical severity, and respiratory support type. However, L/A ratio was found to be a more valuable predictor of mortality than lactate alone.

Sepsis is a life-threating cause in childhood ages. The recognition and treatment early are significant for decreasing mortality. Sepsis has many factors and various biomarkers function in the pathogenesis, the stress indicators oxidants increased and antioxidants decreased. The objective of our study was to investigate the levels of thiol disulfides with and without sepsis in a pediatric intensive care unit (PICU). A cohort study was conducted between October 2022 and March 2023 at the PICU, comprising 64 with sepsis and 62 children without sepsis. Blood samples from sepsis and the control group were collected and centrifuged. Subsequently, the samples were stored at -80 °C until the day of the experiment. Once the requisite number of patients had been enrolled, the thiol-disulfide values in the collected samples were analysed in accordance with the ELISA kit method. The research parameters investigated, namely total oxidant status, plasma 8-OHdG, total-native thiol and native/total thiol percent ratio, were found to be considerably elevated in the sepsis group in comparison to the control (p < 0.05). Furthermore, the oxidative stress parameters investigated (total antioxidant status, paraoxonase 1 activity, disulfide, disulfide/native thiol percent ratio, disulfide/total thiol percent ratio) were found to be significantly lower in the sepsis group than in control (p < 0.05). In our study as well, we detected all antioxidant parameters are low and oxidant parameters are statistically significantly higher in sepsis. Our study posits that thiol-disulfide levels have the potential to serve as a diagnostic tool in conjunction with traditional established biomarkers of inflammation in critically ill children in the PICU who are being treated for sepsis. Not applicable.

Lupin beans are the yellow legume seeds of the genus Lupinus. They are traditionally eaten as a pickled snack in many countries. Bitter lupin beans have a high amount of alkaloids called lupanine. Because the alkaloid is responsible for anticholinergic toxidrome, the beans should pass a debittering process before consumption. Only few pediatric cases of lupin bean intoxication were reported. We present a 12-year-old boy who visited the emergency department for the unexpected onset of anticholinergic toxidrome.

Background: The inability to ensure adequate nutrition for patients, and failure to provide adequate calorie and protein intake, result in malnutrition, leading to increased morbidity and mortality. The present study assesses the two approaches to enteral nutrition—intermittent and continuous enteral feeding—in critically ill pediatric patients in Türkiye to determine the superiority of one method over the other. Methods: Included in this multicenter prospective study were patients receiving enteral nutrition via a tube who were followed up over a 3-month period. Anthropometric data, calorie and protein intake, and signs of feeding intolerance were evaluated in a comparison of the different feeding methods. Results: A total of 510 patients were examined. In the continuous enteral feeding (CEF) group, 20.2% of patients developed metabolic abnormalities, and 49.5% experienced enteral nutrition intolerance, both of which were higher than in the intermittent enteral feeding (IEF) group, and the differences were statistically significant. No significant differences were observed between the two feeding methods in terms of reaching the target calorie intake on days 2 and 7 (p > 0.05). On day 7, there were significant differences between the two feeding methods in terms of calorie and protein intake (p = 0.023 and 0.014, respectively). Conclusions: In the present study, assessing the IEF and CEF approaches to enteral nutrition, critically ill pediatric patients receiving intermittent feeding exhibited lower rates of enteral nutrition intolerance and metabolic abnormalities. Furthermore, the calorie and protein intake on day 7 were noted to be higher in the IEF group than in the CEF group. Further randomized controlled trials are needed to confirm the findings of the present study.