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Ferritin levels in children with severe sepsis and septic shock

Authors

  • Pedro Celiny Ramos Garcia,

    1. Pediatric Intensive Care Unit, Department of Pediatrics, Hospital São Lucas da PUCRS, Porto Alegre, Brazil
    2. Medical School, Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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  • Fernanda Longhi,

    1. Pediatric Intensive Care Unit, Department of Pediatrics, Hospital São Lucas da PUCRS, Porto Alegre, Brazil
    2. Medical School, Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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  • Ricardo Garcia Branco,

    1. Department of Paediatrics, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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  • Jefferson Pedro Piva,

    1. Pediatric Intensive Care Unit, Department of Pediatrics, Hospital São Lucas da PUCRS, Porto Alegre, Brazil
    2. Medical School, Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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  • Dani Lacks,

    1. Pediatric Intensive Care Unit, Department of Pediatrics, Hospital São Lucas da PUCRS, Porto Alegre, Brazil
    2. Medical School, Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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  • Robert Charles Tasker

    1. Department of Paediatrics, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Correspondence
Ricardo Garcia Branco, Department of Paediatrics, Box 116, University of Cambridge, School of Clinical Medicine, Addenbrookes Hospital, Hills Road, Cambridge, CB2 2QQ, United Kingdom. Tel.: +44 1223 217715 | Fax: + 44 1223 586794 | Email: brancori@terra.com.br

Abstract

Aim: To evaluate serum ferritin level in children with severe sepsis and septic shock and its association with mortality.

Method: A cohort study of 36 children aged 1 month–16 years with severe sepsis or septic shock requiring intensive care was conducted. Serum ferritin levels were measured at the time of diagnosis of sepsis and a ferritin index (FI = observed serum ferritin divided by the upper limit of normal ferritin for age and gender) was calculated.

Results: The median age (range) of the children was 6 (2–100) months. Ferritin was <200 ng/mL in 13 children, 200–500 ng/mL in 11 children and >500 ng/mL in 12 children. The mortality associated with these groups was 23%, 9% and 58%, respectively. A ferritin >500 ng/mL was associated with a 3.2 (1.3–7.9) relative risk of death (p = 0.01). FI of 1.7 was the best cutoff value for identifying those who died. In a logistic regression analysis, ferritin level and PRISM were independently associated with mortality.

Conclusions: Ferritin is raised in children with septic shock and high ferritin level is associated with poorer outcome.

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