Abstract
BACKGROUND: This study investigated the effects of cardiac biomarkers at admission on the prognosis and timing of vasoactive drug administration in children with sepsis according to the 2005 SIRS criteria. Additionally, the Phoenix sepsis criteria have been applied to patients and examined in detail. METHODS: The study was conducted as a single-center retrospective study between March 2019 and 2022. Laboratory parameters and echocardiographic measurements at admission were evaluated. The primary outcomes are mortality and vasoactive drug use. Receiver operating characteristic (ROC) analysis was used to determine the time to initiate vasoactive drugs. RESULTS: In this study 162 (45.1% females) children with sepsis were included. The total mortality was 26.4%. Among the 162 patients, 28.6% were not classified as having sepsis according to the Phoenix 4 criteria and 24.2% according to the Phoenix 8 criteria. Among the non-surviving patients, 9.3% were not classified as sepsis according to the Phoenix 4 criteria (p = 0.001) and 7% according to the Phoenix 8 criteria (p = 0.002). ROC analysis revealed that a pro-BNP value of ≥ 1835 ng/L predicted the initiation of vasoactive therapy with 73.1% sensitivity and 90.9% specificity (p = 0.002). CONCLUSIONS: Laboratory parameters such as pro-BNP obtained in the early stages of the disease could serve as good guides for in determining the timing of initiation of vasoactive drug therapy. Furthermore, the fact that children who died did not meet the Phoenix sepsis criteria raises concerns about the ability of these criteria to detect sepsis at an early stage.