Related Experiment Video
Updated: Sep 5, 2025
Evaluation of a Reliable Biomarker in a Cecal Ligation and Puncture-Induced Mouse Model of Sepsis
Published on: December 9, 2022
Serum Cystatin C Level Monitoring for Intervention Opportunity of CBP in Children with Severe Sepsis
Weikai Wang1, Yi Qiang2, Zhongbin Tao3
1Department of PICU, Gansu Provincial Maternity and Child-Care Hospital, The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou 730050, Gansu, China.
Insights
Early monitoring of serum cystatin C (Cys C) levels and initiating continuous blood purification (CBP) within 24 hours can improve outcomes for children with severe sepsis. This timely intervention is crucial for better disease management and reduced mortality.
Area of Science:
- Pediatric Intensive Care
- Nephrology
- Critical Care Medicine
Background:
- Severe sepsis in children is a critical condition requiring timely intervention.
- Continuous blood purification (CBP) is a life-support technology used in pediatric intensive care units (PICUs).
- Serum cystatin C (Cys C) is a biomarker that may indicate kidney function and sepsis progression.
Purpose of the Study:
- To evaluate the clinical value of monitoring serum Cys C levels for guiding CBP intervention in children with severe sepsis.
- To determine if early CBP initiation based on Cys C levels impacts prognosis.
Main Methods:
- Retrospective analysis of 67 children with severe sepsis receiving CBP in the PICU.
- Children were grouped based on the time interval between elevated serum Cys C (>15 mg/L) and CBP initiation (<24h, 24-48h, >48h).
- Clinical data, including severity scores (APACHE II, SOFA) and biochemical parameters, were analyzed to identify prognostic factors.
Main Results:
- Initiating CBP within 24 hours of elevated Cys C (Group A) was associated with significantly shorter intervals from PICU admission to CBP initiation compared to other groups.
- Group A showed lower mortality rates and improved clinical parameters (lower APACHE II, SOFA scores, BUN, SCr) compared to Group C (>48h).
- SOFA scores ≥5 and CBP initiation ≥24 hours after Cys C elevation were independent predictors of poor prognosis.
Conclusions:
- Initiating continuous blood purification (CBP) within 24 hours of elevated serum cystatin C (Cys C) levels shows potential for better management of severe sepsis in children.
- Serum Cys C monitoring provides valuable instruction for timely CBP intervention, potentially improving patient outcomes.
Objective:
The aim of this study is to investigate the instruction value of the serum cystatin C (Cys C) level monitoring for intervention opportunity of continuous blood purification technology (CBP) in children with severe sepsis.
Methods:
67 children with severe sepsis in the pediatric intensive care unit (PICU) with CBP treatment were retrospectively selected from May 2016 to April 2020. According to the time intervals between the time point of serum Cys C level began to increase (>15 mg/L) and the time point of CBP began, all children were divided into group A (<24 h, 29 cases), group B (24-48 h, 22 cases), and group C (>48 h, 16 cases). The children's general characteristics, vital signs, biochemical parameters, acute physiology and chronic health evaluation (APACHE II), and sequential organ failure assessment (SOFA) scores were evaluated. The influence factors of prognosis of children with severe sepsis were analyzed by multivariate regression analysis.
Results:
The intervals between the time point of PICU hospitalization and the time point of CBP began and the times of CBP in group A were significantly more than those in group B and C (P < 0.05). There was no statistically significant duration of CBP among three groups (P > 0.05). After follow-up of 28 d, there was no significant difference on the occurrence of coagulation disorders and hypovolemic shock induced by CBP among three groups (P > 0.05). However, the mortality of children in group A was lower than that in group C (P < 0.05). Children in group A had lower APACHE II scores, SOFA scores, serum K+, blood urea nitrogen (BUN), serum creatine (SCr), partial pressure of carbon dioxide (PCO2), and higher partial pressure of oxygen (PO2) than those of children in group C after CBP. (P < 0.05). SOFA scores ≥5 after CBP treatment and the time intervals between the time point of serum Cys C level began to increase (>15 mg/L) and the time point of CBP began ≥24 h were the independent influence factors on the prognosis by multivariate regression analysis.
Conclusion:
There are significant evidences that continuous blood purification technology within 24 h of serum Cys C level may better control the condition of children with severe sepsis.
More Related Videos
07:03Standardized Colon Ascendens Stent Peritonitis in Rats - a Simple, Feasible Animal Model to Induce Septic Acute Kidney Injury
Published on: February 15, 2022
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Related Concept Videos
01:24Serum Studies: Renal Function Tests
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:26Nephrotic Syndrome II : Assessment and Medical Management
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:24Nephrotic Syndrome III : Nursing Management
01:28Chronic Kidney Disease III: Interprofessional Care