The Kinetic Profiles of Copeptin and Mid Regional Proadrenomedullin (MR-proADM) in Pediatric Lower Respiratory Tract Infections

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2022 Mar 10

PMID 35271609

Authors

Philipp Baumann

Aline Fuchs

Verena Gotta

Nicole Ritz

Gurli Baer

Jessica M Bonhoeffer

Michael Buettcher

Ulrich Heininger

Gabor Szinnai

Jan Bonhoeffer

Affiliations

Soon will be listed here.

Abstract

Background: Kinetics of copeptin and mid regional proadrenomedullin (MR-proADM) during febrile pediatric lower respiratory tract infections (LRTI) are unknown. We aimed to analyze kinetic profiles of copeptin and MR-proADM and the impact of clinical and laboratory factors on those biomarkers.

Methods: This is a retrospective post-hoc analysis of a randomized controlled trial, evaluating procalcitonin guidance for antibiotic treatment of LRTI (ProPAED-study). In 175 pediatric patients presenting to the emergency department plasma copeptin and MR-proADM concentrations were determined on day 1, 3, and 5. Their association with clinical characteristics and other inflammatory biomarkers were tested by non-linear mixed effect modelling.

Results: Median copeptin and MR-proADM values were elevated on day 1 and decreased during on day 3 and 5 (-26%; -34%, respectively). The initial concentrations of MR-proADM at inclusion were higher in patients receiving antibiotics intravenously compared to oral administration (difference 0.62 pmol/L, 95%CI 0.44;1.42, p<0.001). Intensive care unit (ICU) admission was associated with a daily increase of MR-proADM (increase/day 1.03 pmol/L, 95%CI 0.43;1.50, p<0.001). Positive blood culture in patients with antibiotic treatment and negative results on nasopharyngeal aspirates, or negative blood culture were associated with a decreasing MR-proADM (decrease/day -0.85 pmol/L, 95%CI -0.45;-1.44), p<0.001).

Conclusion: Elevated MR-proADM and increases thereof were associated with ICU admission suggesting the potential as a prognostic factor for severe pediatric LRTI. MR-proADM might only bear limited value for decision making on stopping antibiotics due to its slow decrease. Copeptin had no added value in our setting.

Citing Articles

Comprehensive Assessment of Mid-Regional Proadrenomedullin, Procalcitonin, Neuron-Specific Enolase and Protein S100 for Predicting Pediatric Severe Trauma Outcomes.

Zakirov R, Petrichuk S, Yanyushkina O, Semikina E, Vershinina M, Karaseva O Biomedicines. 2023; 11(8).

PMID: 37626802 PMC: 10452732. DOI: 10.3390/biomedicines11082306.

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