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Absolute Neutrophil Count as a Septic Shock Predictor in Pediatric Emergency Room

Received: 9 March 2015     Accepted: 22 March 2015     Published: 26 March 2015
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Abstract

Introduction: The Absolute Neutrophil Count (ANC) is a neutrophil percentage multiplied by the total leukocytes in blood. Its use as a prognostic indicator has been studied in a variety of circumstances, especially sepsis in the neonates and children. Objective: This research aims to investigate the roles of the ANC as the predictor of the septic shock. Methods: It was a prospective cohort study. The data were collected when the patients were brought into the Pediatric Emergency Room (PER) of Dr. Wahidin Sudirohusodo Hospital, Makassar in September through December 2012. The ANC total of the treated patients was counted and then the patients were put into two groups: the group with ANC < 1500/mm3 and the group with ANC ≥ 1500/mm3. The individual health condition of each ANC group was observed carefully in order to determine whether the patients suffered from the septic shock or not. Results: The incidence of the septic shock in the ANC group of < 1500/mm3 was greater compared to that of ≥ 1500/mm3 with the p value = 0.015 (p < 0.05). Besides, it was found that the odds ratio = 6.333, CI = 95% (1.523 – 26.335). No significant differences of septic shock incidence were found between age, nutritional status, sex and infectious/non infectious disease. Conclusion: The mean value of the ANC in patients with septic shock is lower compared with non septic shock. The incidence of septic shock in patients with ANC ≥ 1500/ mm3 group; ANC can be used as predictor of impending the septic shock.

Published in American Journal of Clinical and Experimental Medicine (Volume 3, Issue 2)
DOI 10.11648/j.ajcem.20150302.14
Page(s) 68-72
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Septic Shock, Sepsis, ANC, Predictor Factor, Children

References
[1] Shanle TP, Wheeler DS, Wong HS. Sepsis. Pediatric critical care medicine: basic science and clinical evidence. Springer-Verlag. London. 2007; 1424-44
[2] Yuniar I, Dewi R, Pudjiadi A. Epidemiology of pediatric sepsis in pediatric intensive care unit. FKUI-RSCM. Paediatrica Indonesiana. 2010; 50:2
[3] Goldstein B, Giroir B, Randolph A. The members of the International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005; 6:2-7
[4] Cruz AT, Perry AM, Williams EA, Graf JM, Wuestner ER. Implementation of Goal Directed Therapy for Children With Suspected Sepsis in the Emergency Department. Pediatrics. 2011; 127:758-66
[5] Hotchkiss RS, Karl IE. The Pathophysiology and Treatment of Sepsis.N Engl J Med. 2003;384: 138-50
[6] Agodi A, Barchitta M, Trigilia C, Barone P, Marino S, Garozzo R, La Rosa M, et al. Neutrophil counts distinguish between malignancy and arthritis in children with musculoskeletal pain: a case-control study.BMC Pediatrics.2013;13(15):1-7
[7] Capsoni F, Meroni PL, Zocchi MR, Plebani AM, Vezio M. Effect of corticosteroids on neutrophil function: inhibition of antibody-dependent cell mediated cytotoxicity (ADCC). J Immunopharmacol. 1983; 5(3):217-30
[8] Conrad L, Dale DC, Klebanoff SJ. Glucocorticoids Inhibit Apoptosis of Human Neutrophils. Blood Journal.1995; 86:3181–88
[9] Watson RS, Carcilo JA, Linde-Zwirble WT, Clermont G, Lidicker J, Angus DC. The Epidemiology of Severe Sepsis in Children in the United States.Am J Respir Crit Care Med. 2003;167(5):695-701
[10] Heffner AC, Horton JM, Marchick MR, Jones AE. Etiology of illness in patients with severe sepsis admitted to the hospital from the emergency department. Clin Infect Dis. 2010; 50(6): 814-20
[11] Schroeder J, Kahlke V, Staubach KH, Zabel P, Stuber F. Gender differ- national point-prevalence survey. J Pediatr. 2001; 39:821-7
[12] Aledo A, Heller G, Ren L, Gardner S, Dunkel I, McKay SW, Flombaum C, et al. Septicemia and septic shock in pediatric patients: 140 consecutive cases on a pediatric hematology-oncology service.J Pediatr Hemato Oncol. 1998; 20(3):215-21
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  • APA Style

    Lucy Amelia, Idham Jaya Ganda, Dasril Daud. (2015). Absolute Neutrophil Count as a Septic Shock Predictor in Pediatric Emergency Room. American Journal of Clinical and Experimental Medicine, 3(2), 68-72. https://doi.org/10.11648/j.ajcem.20150302.14

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    ACS Style

    Lucy Amelia; Idham Jaya Ganda; Dasril Daud. Absolute Neutrophil Count as a Septic Shock Predictor in Pediatric Emergency Room. Am. J. Clin. Exp. Med. 2015, 3(2), 68-72. doi: 10.11648/j.ajcem.20150302.14

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    AMA Style

    Lucy Amelia, Idham Jaya Ganda, Dasril Daud. Absolute Neutrophil Count as a Septic Shock Predictor in Pediatric Emergency Room. Am J Clin Exp Med. 2015;3(2):68-72. doi: 10.11648/j.ajcem.20150302.14

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  • @article{10.11648/j.ajcem.20150302.14,
      author = {Lucy Amelia and Idham Jaya Ganda and Dasril Daud},
      title = {Absolute Neutrophil Count as a Septic Shock Predictor in Pediatric Emergency Room},
      journal = {American Journal of Clinical and Experimental Medicine},
      volume = {3},
      number = {2},
      pages = {68-72},
      doi = {10.11648/j.ajcem.20150302.14},
      url = {https://doi.org/10.11648/j.ajcem.20150302.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20150302.14},
      abstract = {Introduction: The Absolute Neutrophil Count (ANC) is a neutrophil percentage multiplied by the total leukocytes in blood. Its use as a prognostic indicator has been studied in a variety of circumstances, especially sepsis in the neonates and children. Objective: This research aims to investigate the roles of the ANC as the predictor of the septic shock. Methods: It was a prospective cohort study. The data were collected when the patients were brought into the Pediatric Emergency Room (PER) of Dr. Wahidin Sudirohusodo Hospital, Makassar in September through December 2012. The ANC total of the treated patients was counted and then the patients were put into two groups: the group with ANC < 1500/mm3 and the group with ANC ≥ 1500/mm3. The individual health condition of each ANC group was observed carefully in order to determine whether the patients suffered from the septic shock or not. Results: The incidence of the septic shock in the ANC group of < 1500/mm3 was greater compared to that of ≥ 1500/mm3 with the p value = 0.015 (p < 0.05). Besides, it was found that the odds ratio = 6.333, CI = 95% (1.523 – 26.335). No significant differences of septic shock incidence were found between age, nutritional status, sex and infectious/non infectious disease. Conclusion: The mean value of the ANC in patients with septic shock is lower compared with non septic shock. The incidence of septic shock in patients with ANC ≥ 1500/ mm3 group; ANC can be used as predictor of impending the septic shock.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Absolute Neutrophil Count as a Septic Shock Predictor in Pediatric Emergency Room
    AU  - Lucy Amelia
    AU  - Idham Jaya Ganda
    AU  - Dasril Daud
    Y1  - 2015/03/26
    PY  - 2015
    N1  - https://doi.org/10.11648/j.ajcem.20150302.14
    DO  - 10.11648/j.ajcem.20150302.14
    T2  - American Journal of Clinical and Experimental Medicine
    JF  - American Journal of Clinical and Experimental Medicine
    JO  - American Journal of Clinical and Experimental Medicine
    SP  - 68
    EP  - 72
    PB  - Science Publishing Group
    SN  - 2330-8133
    UR  - https://doi.org/10.11648/j.ajcem.20150302.14
    AB  - Introduction: The Absolute Neutrophil Count (ANC) is a neutrophil percentage multiplied by the total leukocytes in blood. Its use as a prognostic indicator has been studied in a variety of circumstances, especially sepsis in the neonates and children. Objective: This research aims to investigate the roles of the ANC as the predictor of the septic shock. Methods: It was a prospective cohort study. The data were collected when the patients were brought into the Pediatric Emergency Room (PER) of Dr. Wahidin Sudirohusodo Hospital, Makassar in September through December 2012. The ANC total of the treated patients was counted and then the patients were put into two groups: the group with ANC < 1500/mm3 and the group with ANC ≥ 1500/mm3. The individual health condition of each ANC group was observed carefully in order to determine whether the patients suffered from the septic shock or not. Results: The incidence of the septic shock in the ANC group of < 1500/mm3 was greater compared to that of ≥ 1500/mm3 with the p value = 0.015 (p < 0.05). Besides, it was found that the odds ratio = 6.333, CI = 95% (1.523 – 26.335). No significant differences of septic shock incidence were found between age, nutritional status, sex and infectious/non infectious disease. Conclusion: The mean value of the ANC in patients with septic shock is lower compared with non septic shock. The incidence of septic shock in patients with ANC ≥ 1500/ mm3 group; ANC can be used as predictor of impending the septic shock.
    VL  - 3
    IS  - 2
    ER  - 

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Author Information
  • Department of Pediatrics, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi, Indonesia

  • Department of Pediatrics, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi, Indonesia

  • Department of Pediatrics, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi, Indonesia

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