University of Calgary

Study suggests clues for significantly reducing pediatric septic shock mortality rate

UToday HomeJuly 17, 2013

By Marie-Helene Thibeault

Postdoctoral fellow in biology, Beata Mickiewicz, and professor Hans Vogel are among a group of researchers at the University of Calgary who identified new biomarkers for the early detection in pediatric patients of the sepsis disease. Missing: Brent WinsPostdoctoral fellow in biology science, Beata Mickiewicz, and professor Hans Vogel are among a group of researchers at the University of Calgary who identified new biomarkers for the early detection in pediatric patients of the sepsis disease. Missing: Brent Winston. Photo by Marie-Helene ThibeaultEvery year, 10 percent of Canadian children afflicted by systemic inflammatory response syndrome succumb to sepsis. In developing countries, sepsis accounts for 60 to 80 per cent of lost lives per year in childhood, killing more than six million neonates and children yearly.

The life-threatening disease is caused by a generalized infection resulting from severe response to bacteria or other germs and can feature rapid degradation of patients’ health.

Beata Mickiewicz, postdoctoral fellow in biology science, recently published a paper in the American Journal of Respiratory and Critical Care Medicine in which she identifies new markers for the early detection of the illness. Co-authored by professor Hans Vogel and intensive care specialists Brent Winston from Calgary and Hector Wong from Cincinatti, the research points to new biomarkers for the early identification and rapid treatment of the disease.

When time is of the essence

Sepsis occurs when chemicals released into the bloodstream to fight an infection cause inflammation throughout the body. This inflammation can trigger a cascade of damaging changes to multiple organ systems, causing them to fail.

In infants, the condition is particularly threatening because of their weak and undeveloped immune systems. For every hour of septic shock without appropriate resuscitation and restoration of blood pressure, mortality risks increase by 40 per cent.

“The diagnosis of sepsis remains a clinical challenge in pediatric critical care, especially because of the disease’s complexity and heterogeneity,” explains Mickiewicz. “The first hours following the diagnosis of septic shock are ‘golden hours’ for patients’ survival. Through early detection as well as aggressive and goal-directed treatment using antibiotics and large amounts of intravenous fluids, chances of survival improve,” she adds.

Fast tracking detection by looking at new biomarkers

In the past, practitioners relied on biomarkers such as C-reactive protein or procalcitonin to diagnose sepsis. However, “none of these markers are adequately specific and sensitive,” points out Mickiewicz.

“Considering the complexity of sepsis, just only one marker is not specific and sensitive enough for accurate diagnosis and prognosis,” explains Mickiewicz.

In an attempt to overcome this obstacle, the researchers explored the potential use of Nuclear Magnetic Resonance (NMR) metabolomics for detecting the onset of sepsis in pediatric patients.

Metabolomics is defined as “the quantitative measurement of the metabolic response of living systems to pathophysiological stimuli or genetic modification” and is based on the analytical techniques such as NMR and/or mass spectrometry.

“In our study, we used NMR technology to rapidly identify metabolites — the waste products of chemical reactions in the cell — in serum samples,” Mickiewicz says. “Metabolomics gives a combination of various biomarkers — a biopattern — which is characteristic for sepsis,” she adds.

So far, the only metabolomics studies associated with early prognostic evaluation of sepsis were described for animal models.

“We discovered that metabolomics could predict mortality of septic shock patients on day one of their admission to a pediatric intensive care unit (PICU) more accurately than conventional methods.

“Our study presents metabolomics as a very promising method for the diagnostic and early prognostic evaluation of septic shock patients in the PICU,” concludes Mickiewicz.

The research was supported by the Alberta Sepsis Network, which is sponsored in turn by Alberta Innovates Health Solutions.


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