الفهرس 
Pediatric Intensive CareOnly 14 pages are availabe for public view
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Abstract
Pediatric critical illness (outside of the neonatal period) is often unexpected and is
accompanied by rapid deterioration so children present to the closest hospital for care. Injury,
infections, and respiratory disease (including asthma/bronchiolitis) are among the most
common reasons for hospital admission and can require critical care level services. Hospitals
provide varying levels of pediatric care including general hospitals without designated
pediatric rooms, a dedicated pediatric unit/floor, a designated pediatric hospital within a
larger adults system, and a complete freestanding pediatric hospital.
An abundant amino acid in the human body, glutamine (Gln) has many important
metabolic roles that may protect or promote tissue integrity and enhance the immune system.
Low plasma and tissue levels of Gln in the critically ill suggest that demand may exceed
endogenous supply. A relative deficiency of Gln in such patients could compromise recovery
and result in prolonged illness and an increase in late mortality.
Our aim of this study was to assess the level of Plasma Glutamine and its relationship
with clinical outcomes in critically ill children.
A prospective cohort study was conducted on 80 children with age ranging from 1
month to 18 years. 60 critically ill children (patient group), admitted to PICU of Menoufia
University Hospitals, and 20 children apparently healthy children, matched to age and sex to
patient group (control group). For all children: Detailed history taking, Clinical examination.
Investigations: complete blood count, liver function test, renal function test, ultrasound.
Specific investigations: plasma amino acid Glutamine. PRISM score was calculated within
24 hrs of admission for each patient
This study revealed that
The most common cause for admission was related to the Central nervous
system followed by respiratory system while the least cause of admission was
related to the renal system.
There was positive correlation between the low plasma glutamine concentration
groups with the following: Multi-organ dysfunction (MODS) on admission,
high PRISM score, non- survived Patient and the need for mechanical
ventilation, use of vasoactive drugs and parenteral nutrition.
High PRISM score, low plasma glutamine concentration, MODS on admission
and the use of vasoactive drugs and parenteral nutrition were the potential risk
factors for mortality in the studied patients.
According to ROC curve analysis, AUC for plasma glutamine concentration
was 0.849.Best cutoff point of plasma glutamine level was 247 mg/dl with
sensitivity of 85.11% and specificity of 84.62 %. AUC for PRISM score was
0.817 .Best cutoff point for PRISM score was 23.5 mg/dl with sensitivity of
78.72% and specificity of 84.62%.