Early Identification of Sepsis in Children

NCT ID: NCT03884595

Last Updated: 2019-12-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-12-01

Study Completion Date

2022-01-31

Brief Summary

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This observational nation-wide study is focused on evaluation of the new possible biomarkers for pediatric sepsis and their specificity/sensitivity in combination with usual diagnostic markers for sepsis in the terms of early identification of sepsis, severe sepsis, and septic shock.

Detailed Description

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The understanding of sepsis pathophysiology underwent a great progress during the last decades and the therapy of sepsis is in the focus of the research for many years, but sepsis is still one of the main causes of death in the ICUs around the world. Systemic inflammatory response syndrome (SIRS) is closely connected with the sepsis development, but SIRS also represents a high risk of organ dysfunction in non-infectious patients (trauma, stress, cardiopulmonary arrest). Early diagnosis and prevention of the organ dysfunction are the mainstay of the correct and timely therapy, but currently there is no reliable, quick and simple method for the diagnosis of sepsis. And also there is no generally accepted clinical or laboratory parameter, which can be used to differentiate between sepsis and SIRS.

There are some commonly available biomarkers that showed promising results in critically ill adult patients. Those include immature platelet fraction (IPF), immature granulocytes (IG) count and nucleated red blood cells (NRBC) count. The knowledge of their variability in different phases of illness (SIRS/sepsis/severe sepsis/septic shock) in pediatric patients is very limited, as is their connection with other generally used markers of infection (CRP, procalcitonin, presepsin).

This study is strictly non-interventional and focused on usability of above mentioned biomarkers in the early diagnosis of sepsis/SIRS and on the reduction of morbidity/mortality of pediatric intensive care unit (PICU) patients with sepsis/SIRS.

In all patients admitted to PICU in selected study period, the inflammation markers - C-reactive protein (CRP), procalcitonin (PCT), presepsin (soluble cluster of differentiation 14-subtypes) and full blood count parameters -IPF,IG,NRBC will be measured at the time of admission and on 3rd, 5th and 7th day of stay in intensive care. The organ dysfunction score will be evaluated daily.

Conditions

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Sepsis Shock, Septic Sepsis, Severe SIRS

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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No SIRS

Children without clinical signs of SIRS, according to Goldstein criteria.

IG, IPF, NRBC, CRP, PCT, presepsin

Intervention Type DIAGNOSTIC_TEST

Assessment of blood cell count parameters and inflammation markers - IG, IPF, NRBC, CRP, PCT, presepsin according to study group.

SIRS

Children with clinical signs of SIRS, according to Goldstein criteria.

IG, IPF, NRBC, CRP, PCT, presepsin

Intervention Type DIAGNOSTIC_TEST

Assessment of blood cell count parameters and inflammation markers - IG, IPF, NRBC, CRP, PCT, presepsin according to study group.

Sepsis

Children with clinical signs of sepsis, according to Goldstein criteria.

IG, IPF, NRBC, CRP, PCT, presepsin

Intervention Type DIAGNOSTIC_TEST

Assessment of blood cell count parameters and inflammation markers - IG, IPF, NRBC, CRP, PCT, presepsin according to study group.

Severe sepsis

Children with clinical signs of severe sepsis, according to Goldstein criteria.

IG, IPF, NRBC, CRP, PCT, presepsin

Intervention Type DIAGNOSTIC_TEST

Assessment of blood cell count parameters and inflammation markers - IG, IPF, NRBC, CRP, PCT, presepsin according to study group.

Septic Shock

Children with clinical signs of septic shock, according to Goldstein criteria.

IG, IPF, NRBC, CRP, PCT, presepsin

Intervention Type DIAGNOSTIC_TEST

Assessment of blood cell count parameters and inflammation markers - IG, IPF, NRBC, CRP, PCT, presepsin according to study group.

Interventions

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IG, IPF, NRBC, CRP, PCT, presepsin

Assessment of blood cell count parameters and inflammation markers - IG, IPF, NRBC, CRP, PCT, presepsin according to study group.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* all patients admitted to PICU until the 18th year of age
* expected length of stay \> 48 hours

Exclusion Criteria

* oncology patients
* immunosuppressive therapy
* immunostimulant therapy
* autoimmune disease
* post-organ transplant patient
* thrombocytopaenia, thrombocytopathy
Minimum Eligible Age

28 Days

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Brno University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Michal Fedora

Assoc. prof. Michal Fedora, MD., Ph.D.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Petr Dominik, MD.

Role: PRINCIPAL_INVESTIGATOR

University Hospital Brno

Locations

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University Hospital Brno

Brno, , Czechia

Site Status RECRUITING

Countries

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Czechia

Central Contacts

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Michal Fedora, MD., Ph.D.

Role: CONTACT

+420532234698

Jozef Klucka, MD.

Role: CONTACT

+420532234696

Facility Contacts

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Michal Fedora, MD., Ph.D.

Role: primary

+420532234698

Jozef Klučka, MD.

Role: backup

+420532234696

References

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Goldstein B, Giroir B, Randolph A; International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005 Jan;6(1):2-8. doi: 10.1097/01.PCC.0000149131.72248.E6.

Reference Type BACKGROUND
PMID: 15636651 (View on PubMed)

De Blasi RA, Cardelli P, Costante A, Sandri M, Mercieri M, Arcioni R. Immature platelet fraction in predicting sepsis in critically ill patients. Intensive Care Med. 2013 Apr;39(4):636-43. doi: 10.1007/s00134-012-2725-7. Epub 2012 Oct 24.

Reference Type BACKGROUND
PMID: 23093245 (View on PubMed)

Nierhaus A, Klatte S, Linssen J, Eismann NM, Wichmann D, Hedke J, Braune SA, Kluge S. Revisiting the white blood cell count: immature granulocytes count as a diagnostic marker to discriminate between SIRS and sepsis--a prospective, observational study. BMC Immunol. 2013 Feb 12;14:8. doi: 10.1186/1471-2172-14-8.

Reference Type BACKGROUND
PMID: 23398965 (View on PubMed)

Liu Y, Hou JH, Li Q, Chen KJ, Wang SN, Wang JM. Biomarkers for diagnosis of sepsis in patients with systemic inflammatory response syndrome: a systematic review and meta-analysis. Springerplus. 2016 Dec 12;5(1):2091. doi: 10.1186/s40064-016-3591-5. eCollection 2016.

Reference Type BACKGROUND
PMID: 28028489 (View on PubMed)

Enz Hubert RM, Rodrigues MV, Andreguetto BD, Santos TM, de Fatima Pereira Gilberti M, de Castro V, Annichino-Bizzacchi JM, Dragosavac D, Carvalho-Filho MA, De Paula EV. Association of the immature platelet fraction with sepsis diagnosis and severity. Sci Rep. 2015 Jan 26;5:8019. doi: 10.1038/srep08019.

Reference Type BACKGROUND
PMID: 25620275 (View on PubMed)

Schaer C, Schmugge M, Frey B. Prognostic value of nucleated red blood cells in critically ill children. Swiss Med Wkly. 2014 Mar 28;144:w13944. doi: 10.4414/smw.2014.13944. eCollection 2014.

Reference Type BACKGROUND
PMID: 24706413 (View on PubMed)

Straney L, Clements A, Parslow RC, Pearson G, Shann F, Alexander J, Slater A; ANZICS Paediatric Study Group and the Paediatric Intensive Care Audit Network. Paediatric index of mortality 3: an updated model for predicting mortality in pediatric intensive care*. Pediatr Crit Care Med. 2013 Sep;14(7):673-81. doi: 10.1097/PCC.0b013e31829760cf.

Reference Type BACKGROUND
PMID: 23863821 (View on PubMed)

Leteurtre S, Duhamel A, Salleron J, Grandbastien B, Lacroix J, Leclerc F; Groupe Francophone de Reanimation et d'Urgences Pediatriques (GFRUP). PELOD-2: an update of the PEdiatric logistic organ dysfunction score. Crit Care Med. 2013 Jul;41(7):1761-73. doi: 10.1097/CCM.0b013e31828a2bbd.

Reference Type BACKGROUND
PMID: 23685639 (View on PubMed)

Other Identifiers

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FNBRNO-2017/01

Identifier Type: -

Identifier Source: org_study_id

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