Impact of Neutrophil Gelatinase-associated Lipocalin A Novel Sepsis Biomarker on PRISM III Score in Predicting Sepsis Severity And Mortality in Pediatric Intensive Care Units (Single Center Study)

Abstract

Abstract Background: Physiological, pathological, and metabolic problems brought on by infection are what define the syndrome of sepsis. Neutrophil granules generated at human sites of infection and inflammation were the source of the first discovery of neutrophil associated gelatinase associated lipocalin (NGAL). Objectives: to evaluate the predictive usefulness of serum NGAL in children with sepsis in the pediatric intensive care unit and to compare it with the clinical score (PRISM III score) that is most frequently used to predict mortality in critically unwell children. ). Patients and methods: In this study 75 patients were included according to the inclusion criteria and divided into three groups 25 each (sepsis, septic shock, and multi-organ failure), and serum NGAL level in those group was measured and compared to 25 healthy controls. Results: Serum NGAL was significantly higher in both septic shock and multi-organ failure groups than in the control group. Positive bacterial cultures were linked to the severe degrees of sepsis which were associated with higher serum NGAL levels. Significant difference in serum NGAL level was found between survivors and non survivors, while no significant difference was found regarding PRISM III score. Conclusion: Serum NGAL is significantly elevated in severe sepsis. Serum NGAL level was superior on the frequently used PRISM III score to predict mortality in critically ill patients with sepsis. So, serum NGAL can be used as a marker for severity and prognosis for mortality in septic pediatric patients.