Abstract
Objective: Disseminated intravascular coagulation (DIC) is one of the most serious hemostatic abnormalities in the pediatric intensive care unit (PICU). The primary treatment for DIC is correction of the underlying disease while the role of antioxidant therapy is controversial. In this study, we aimed to evaluate the levels of vitamin E, selenium and glutathione peroxidase (GPx) activity in DIC patients.
Material and Methods: Between September 2011 and October 2013, 150 patients diagnosed with DIC in the PICU were enrolled in this study. Patients who received blood transfusion within 24 hours before admission to the PICU were excluded. The DIC score was calculated according to the International Society on Thrombosis and Haemostasis diagnostic scoring system, and patients were divided into two groups according to their DIC score (DIC< 5 and DIC ≥5). GİrİŞ Demographic data, age, gender, initial diagnosis, Pediatric Risk of Mortality (PRISM) and Pediatric Logistic Organ Dysfunction (PELOD) scores, selenium, vitamin E levels and GPx activity, were evaluated.results: Participants included 78 boys and 72 girls with a median age of 50 months (12-106 months). In all patients, selenium, vitamin E levels, and GPx were 67.8±36.5 µg/L, 9.7±2.8 mg/L and 82.9±44.3 U/L respectively. Vitamin E, selenium and GPx were significantly lower in the DIC ≥ 5 group (p<0.01, p<0.001 and p<0.001, respectively). We further divided the patients with scores of DIC ≥ 5 into two groups, and the sepsis group had significantly lower selenium, vitamin E, levels and GPx activity (p=0.003, p=0.044, and p=0.007, respectively).conclusion: In patients with DIC, plasma selenium and vitamin E levels and GPx activity were significantly lower in critically ill children. This was more prominent in those with sepsis. We believe that vitamin E and selenium supplementation is useful in treating critically ill patients with DIC, especially those with sepsis. In order to develop treatment algorithms, prospective clinical studies with a larger patient population are warranted
Keywords: Disseminated intravascular coagulation, Glutathione peroxidase activity, Selenium, Vitamin E
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- Değişkenler Ort±SS: ortalama±standart sapma veya n (%) değer olarak tanımlanmıştır. * : Independent Samples T-test, **χ2: ki-kare testi. 20 (%40) 15.6±0.8 14.6±1.5 81.0±4.4 10.5±0.3 97.3±5.4 5 (%18.5) 0.038* 0.002* 0.003* 0.044* 0.007*
