TY - JOUR T1 - Neopterin levels and systemic inflammatory response syndrome in pediatric critically ill patients JO - Anales de Pediatría (English Edition) T2 - AU - Gil-Gómez,Raquel AU - Blasco-Alonso,Javier AU - Sánchez-Yáñez,Pilar AU - Rosa-Camacho,Vanessa AU - Milano,Guillermo SN - 23412879 M3 - 10.1016/j.anpede.2017.02.002 DO - 10.1016/j.anpede.2017.02.002 UR - https://analesdepediatria.org/en-neopterin-levels-systemic-inflammatory-response-articulo-S2341287917300212 AB - IntroductionNeopterin and biopterin are subproducts of redox reactions, which act as cofactor of enzymes responsible for nitric oxide production. We hypothesized that plasma neopterin suffers different evolution during the first days of a critically ill child. MethodsSingle-center prospective observational study in patients 7 days to 14 years admitted to our PICU and that met SIRS criteria. Neopterin and biopterin levels as well as other acute phase reactants were collected at admission and at 24h. ResultsA total of 28 patients were included, 78.9% male, median age 5.04 years (interquartile range [IQR] 1.47–10.26), PRISM II 2.0% (IQR 1.1–5.0). Mechanical ventilation (MV) in 90% of patients, median duration of 6.0h (IQR 3.7–102.0); median PICU length of stay 5.0 days (IQR 2.7–18.7), maximum VIS through 0 (IQR 0–14). Baseline neopterin level 2.3±1.2nmol/l and at 24h 2.3±1.4nmol/l. Baseline biopterin is 1.3±0.5nmol/l and 1.4±0.4nmol/l at 24h. Neopterin levels significantly higher in patients with PICU length of stay >6 days (p=.02), patients who needed MV >24h (p=.023) and those who developed complications (p=.05). Neopterin correlates directly and statistically significant with the duration of MV (rho=.6, p=.011), PICU length of stay (rho=.75, p<.0001) and VIS (rho=.73, p=.001). Additionally, biopterin directly correlates with the PRISM (rho=.61, p=.008). DiscussionThere is a higher neopterin level when longer PICU stay, higher VIS score, longer MV and occurrence of complications, pointing at the involvement of an activation of the cellular immune system. ER -