Paediatrica Indonesiana
Vol 56 No 4 (2016): July 2016

Prognostic value of nitric oxide in pediatric septic shock

Ari L. Runtunuwu (Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado)
Jeanette I. Ch. Manoppo (Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado)
Dasril Daud (Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado)
Irawan Yusuf (Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado)
Idham Jaya Ganda (Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado)



Article Info

Publish Date
31 Aug 2016

Abstract

Background Nitric oxide (NO) play a key role in the pathogenesis of septic shock. Nitrit oxide metabolite is reported as a good predictor for shock although its role as mortality predictor in sepsis still controversial.Objective To assess the serum nitric oxide (NO) levels and outcomes in pediatric patients with septic shock.Methods We conducted a prospective cohort study from January 2013 to April 2014 in Pediatric Intensive Care Unit (PICU) Prof. Dr. R. D. Kandou Hospital, Manado. Subjects were patients aged 1 month-12 years diagnosed with septic shock. We measured initial serum NO and observed its outcomes in all subjects.Results A total of 37 patients with septic shock met the study criteria. Nineteen children were male (51.4%). Seventeen subjects died and 20 subjects survived. The mean age of subjects with septic shock was 37.3 (SD 14.2) months. The mean serum NO level was significantly higher in the group who died [33.2 μM; 95% CI 23.6 to 42.7] than in the group who survived [13.8 μM; 95%CI 11.6 to 15.9] (P<0.01). The serum NO cut-off point for predicting mortality was 16.15 µM. For NO levels of more than 16.15 µM, the positive predictive value was 72.2% and negative predictive value was 78.9% (OR 9.750; 95%CI 2.154 to 44.138).Conclusion In pediatric patients with septic shock, serum NO levels are significantly higher in those who died than in those who survived. Serum nitric oxide level can be used to predict outcomes of patients with septic shock.

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Journal Info

Abbrev

paediatrica-indonesiana

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Paediatrica Indonesiana is a medical journal devoted to the health, in a broad sense, affecting fetuses, infants, children, and adolescents, belonged to the Indonesian Pediatric Society. Its publications are directed to pediatricians and other medical practitioners or researchers at all levels of ...