Related Experiment Video
Updated: Oct 19, 2025
Evaluation of a Reliable Biomarker in a Cecal Ligation and Puncture-Induced Mouse Model of Sepsis
Published on: December 9, 2022
Pediatric Sepsis Biomarker Risk Model Biomarkers and Estimation of Myocardial Dysfunction in Pediatric Septic Shock
Andrew J Lautz1,2, Hector R Wong1,2, Thomas D Ryan1,3
1Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Insights
Pediatric Sepsis Biomarker Risk Model (PSBRM) biomarkers can predict sepsis-associated myocardial dysfunction in children with septic shock. A new PSBRM biomarker-based model reliably estimates this risk, aiding clinical care and trial design.
Area of Science:
- Pediatric critical care medicine
- Cardiology
- Biomarker research
Background:
- Sepsis-associated myocardial dysfunction is a frequent complication in pediatric septic shock, worsening patient outcomes.
- Early identification of at-risk children is crucial for timely intervention and improved clinical trial design.
Purpose of the Study:
- To investigate the association between Pediatric Sepsis Biomarker Risk Model (PSBRM) biomarkers and the risk of sepsis-associated myocardial dysfunction in pediatric septic shock.
- To develop a novel biomarker-based model for estimating this risk.
Main Methods:
- Secondary analysis of a prospective cohort study involving children with septic shock.
- Utilized PSBRM biomarkers and echocardiogram data to assess myocardial function.
- Employed multivariable logistic regression and classification and regression tree methodology for model development.
Main Results:
- Thirty-two out of 181 children (17.7%) exhibited sepsis-associated myocardial dysfunction.
- PSBRM mortality probability was independently associated with myocardial dysfunction (OR, 1.45; P = 0.001).
- The derived PSBRM biomarker-based model demonstrated strong predictive performance (AUC 0.90).
Conclusions:
- A new PSBRM biomarker-based model effectively estimates the risk of sepsis-associated myocardial dysfunction in pediatric septic shock.
- This model has the potential to inform clinical management and enhance pediatric sepsis research.
- Further independent prospective validation of the model is recommended.
Objectives:
Sepsis-associated myocardial dysfunction is common in pediatric septic shock and negatively impacts outcomes. Early estimation of sepsis-associated myocardial dysfunction risk has the potential to inform clinical care and improve clinical trial design. The Pediatric Sepsis Biomarker Risk Model II is validated as a biomarker-based enrichment algorithm to discriminate children with septic shock with high baseline mortality probability. The objectives were to determine if Pediatric Sepsis Biomarker Risk Model biomarkers are associated with risk for sepsis-associated myocardial dysfunction in pediatric septic shock and to develop a biomarker-based model to reliably estimate sepsis-associated myocardial dysfunction risk.
Design:
Secondary analysis of prospective cohort study.
Setting:
Single-center, quaternary-care PICU.
Patients:
Children less than 18 years old admitted to the PICU from 2003 to 2018 who had Pediatric Sepsis Biomarker Risk Model biomarkers measured for determination of Pediatric Sepsis Biomarker Risk Model II mortality probability and an echocardiogram performed within 48 hours of septic shock identification.
Interventions:
None.
Measurements And Main Results:
Pediatric Sepsis Biomarker Risk Model II mortality probability was calculated from serum biomarker concentrations and admission platelet count. Echocardiograms were reread by a single cardiologist blinded to Pediatric Sepsis Biomarker Risk Model II data, and sepsis-associated myocardial dysfunction was defined as left ventricular ejection fraction less than 45% for primary analyses. Multivariable logistic regression analyzed the association of Pediatric Sepsis Biomarker Risk Model II mortality probability with sepsis-associated myocardial dysfunction. Classification and regression tree methodology was employed to derive a Pediatric Sepsis Biomarker Risk Model biomarker-based model for sepsis-associated myocardial dysfunction. Thirty-two of 181 children with septic shock demonstrated sepsis-associated myocardial dysfunction. Pediatric Sepsis Biomarker Risk Model II mortality probability was independently associated with sepsis-associated myocardial dysfunction (odds ratio, 1.45; 95% CI, 1.17-1.81; p = 0.001). Modeling with Pediatric Sepsis Biomarker Risk Model biomarkers estimated sepsis-associated myocardial dysfunction risk with an area under the receiver operating characteristic curve of 0.90 (95% CI, 0.85-0.95). Upon 10-fold cross-validation, the derived model had a summary area under the receiver operating characteristic curve of 0.74. Model characteristics were similar when sepsis-associated myocardial dysfunction was defined by both low left ventricular ejection fraction and abnormal global longitudinal strain.
Conclusions:
A newly derived Pediatric Sepsis Biomarker Risk Model biomarker-based model reliably estimates risk of sepsis-associated myocardial dysfunction in pediatric septic shock, but independent prospective validation is needed.
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...