Early predictive value of endothelial activation biomarkers for pediatric sepsis
Main Article Content
Abstract
Early recognition of pediatric sepsis remains challenging because initial clinical manifestations are often nonspecific, while endothelial activation is closely related to microvascular dysfunction and organ injury. This prospective observational study evaluated the early predictive value of VCAM-1, ICAM-1, E-selectin, and P-selectin measured at enrollment in 144 children aged 1 – 60 months old with suspected infection at Dong Nai Children’s Hospital from May 2021 to October 2022. Sepsis was classified according to the 2005 International Pediatric Sepsis Consensus Conference criteria within 48 hours after admission. Biomarker concentrations were measured in plasma at enrollment and reported in ng/mL. Among 144 children, only 32 had sepsis. All four biomarkers were significantly higher in the sepsis group. VCAM-1 showed the best discrimination, with an AUC of 0.855, followed by E-selectin 0.819, ICAM-1 0.773, and P-selectin 0.689. The optimal VCAM-1 cutoff was 1254.9 ng/mL, yielding 81.3% sensitivity and 93.8% specificity. VCAM-1 may be a promising biomarker to support early prediction of pediatric sepsis in children with suspected infection.
Article Details
Keywords
Pediatric sepsis, VCAM-1, ICAM-1, E-selectin, P-selectin, endothelial activation
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