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The prognostic value of soluble vascular cell adhesion molecules-1 (sVCAM-1) in children with septic shock.

Idham Jaya Ganda, Ikhsan Ali, St. Aizah Lawang, Dasril Daud

Introduction: Septic shock is one of the major causes of mortality and morbidity in children all over the world. Septic shock is identified by endothelial dysfunction due to excessive stimulation of cytokines and chemical mediator. VCAM-1 is one of the adhesive molecules. VCAM-1 can predict the severity of the disease. This study aimed to identify sVCAM-1 as an outcome predictor (survival/non-survival) in children with sepsis. Methods: This prospective cohort study was conducted in Pediatric Intensive Care Unit during February-June 2017. A total of 70 sepsis patients were included. The mean age in improved group was 6.38 years old and median was 4.6 years old, while in dying group was 4.87 and median 2.30 years old. Plasma specimens for sVCAM-1 were collected at admission, then the outcome of the patients were being followed. The diagnosis of septic shock is using the International Pediatric Sepsis Consensus 2005 criteria. Serum sVCAM-1 was measured using Enzyme Linked Immunosorbent Assay technique. Results: The initial level of sVCAM-1 was significantly increased in both groups, but higher in the septic shock group. Cut off point ≥ 313 ng/ml for the sepsis patient becoming septic shock was obtained through the ROC, with sensitivity 100%, specificity 100%, positive predictive value 100%, negative predictive value 100% and Area under Curve (AUC) 1. Conclusion: Initial level of sVCAM-1 can be used as an outcome predictor of sepsis patient in children and limit level ≥ 313 ng/ml is the most optimal cut off point as a prognostic value.