Proadrenomedullin predicts severe disease in children with suspected community-acquired pneumonia
Clinical Infectious Diseases Aug 11, 2020
Florin TA, Ambroggio L, Brokamp C, et al. - Given the greater predictive value of proadrenomedullin (proADM), a vasodilatory peptide with antimicrobial and anti-inflammatory properties, for severe outcomes in adults with community-acquired pneumonia (CAP) relative to C-reactive protein and procalcitonin, researchers here examined the predictive ability of proADM for disease severity across a range of clinical outcomes in children with suspected CAP. In this prospective cohort study, 369 children 3 months to 18 years with CAP in the emergency department (ED) were classified in accordance to disease severity defined as follows: mild (discharged home), mild-moderate (hospitalized but not moderate-severe or severe), moderate-severe (eg, hospitalized with supplemental oxygen, broadening of antibiotics, complicated pneumonia), and severe (eg, vasoactive infusions, chest drainage, severe sepsis). Observations revealed increase in median proADM in correlation with disease severity. They indicated correlation of ProADM with severe disease and its moderately good ability of discriminating children who developed severe disease from those who did not, particularly in radiographic CAP.
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