• Pedro Celiny Ramos Garcia, Fernanda Longhi, Ricardo Garcia Branco, Jefferson Pedro Piva, Dani Lacks, and Robert Charles Tasker.
• Pediatric Intensive Care Unit, Department of Pediatrics, Hospital São Lucas da PUCRS, and Medical School, Pontifica Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
• Acta Paediatr. 2007 Dec 1;96(12):1829-31.

AimTo evaluate serum ferritin level in children with severe sepsis and septic shock and its association with mortality.MethodA cohort study of 36 children aged 1 month-16 years with severe sepsis or septic shock requiring intensive care was conducted. Serum ferritin levels were measured at the time of diagnosis of sepsis and a ferritin index (FI=observed serum ferritin divided by the upper limit of normal ferritin for age and gender) was calculated.ResultsThe median age (range) of the children was 6 (2-100) months. Ferritin was <200 ng/mL in 13 children, 200-500 ng/mL in 11 children and >500 ng/mL in 12 children. The mortality associated with these groups was 23%, 9% and 58%, respectively. A ferritin>500 ng/mL was associated with a 3.2 (1.3-7.9) relative risk of death (p=0.01). FI of 1.7 was the best cutoff value for identifying those who died. In a logistic regression analysis, ferritin level and PRISM were independently associated with mortality.ConclusionsFerritin is raised in children with septic shock and high ferritin level is associated with poorer outcome.

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