Role of Nuclear Factor-Kappa B Activation and Inflammatory Biomarkers in Critically Ill Children

Area of Science:

• Pediatric Critical Care Medicine
• Immunology
• Biomarker Discovery

Background:

• Accurate mortality prediction is crucial for managing critically ill children.
• Serum cytokine levels rise early in critical illness, preceding physiological changes.
• Interleukin-6 (IL-6) is a key inflammatory marker.

Purpose of the Study:

• To evaluate the prognostic value of serum IL-6 and NF-κB levels in predicting mortality in critically ill children.
• To compare the predictive efficacy of IL-6 and NF-κB with the PELOD-2 score.

Main Methods:

• A cross-sectional descriptive study involving 45 critically ill children (40 survivors, 5 non-survivors).
• Serial measurements of serum IL-6 and NF-κB levels.
• Assessment of Pediatric Logistic Organ Dysfunction (PELOD-2) score.

Main Results:

• Non-survivors exhibited significantly higher median IL-6 levels at 24h (1122 pg/ml) and 72h (1263 pg/ml) compared to survivors (564.39 pg/ml and 82 pg/ml, respectively; p<0.0001).
• A consistent increasing trend of IL-6 was observed in non-survivors.
• IL-6 levels demonstrated a strong correlation with illness severity and superior prognostic value over NF-κB.

Conclusions:

• Serum IL-6 is a valuable early biomarker for predicting mortality in critically ill children.
• IL-6 shows greater prognostic utility than NF-κB for mortality prediction in this population.
• Early monitoring of IL-6 levels can aid in risk stratification and patient management.