Multisystem inflammatory syndrome in children: Inputs of BNP, NT-proBNP and Galectin-3.

BACKGROUND: Since the COVID-19 pandemic began, a cohort of Multisystem inflammatory syndrome in children (MIS-C) patients has been described. Cardiac involvement is found in 80-85% patients, typically with cardiac dysfunction with or without cardiogenic shock. Here, three cardiac biomarkers, BNP, NT-proBNP and Galectin-3 were compared for the first time in MIS-C in a unique cohort of hospitalized French children. METHODS: Fourteen children with MIS-C hospitalized at Necker-Enfants Malades for cardiac management during the first three COVID-19 waves (March 2020-March 2021) were included. All had positive SARS-CoV-2 serology and proven cardiac involvement assessed by transthoracic echocardiography. NT-proBNP, BNP and Galectin-3 were measured at admission, discharge and first follow-up clinic. RESULTS: All admission Galectin-3 measurements were comprised within the reference interval, both in patients with and without cardiogenic shock, and did not vary between admission, discharge and first follow-up clinic. Both median admission BNP and NT-proBNP were higher in children with cardiogenic shock than without. Median admission NT-proBNP was higher than its predictive positive value in heart failure in both groups of children, while median BNP was below its negative predictive value in children without cardiogenic shock but with cardiac dysfunction. CONCLUSIONS: Galectin-3 does not seem affected by MIS-C. NT-proBNP seems to increase more precociously than BNP possibly making it a more sensitive marker for screening of heart failure in MIS-C.

Comparison of blood gas results obtained on Abbott i-Stat® and on Radiometer ABL 800 Flex® analyzers Impact for the clinical decision

Background: Point of care testing (POCT) tests are needed to assess severity and to help for triage in hospital and in prehospital settings. Before their use, the analytical performances of POCTs have to be compared with central laboratory reference methods. In this study, we describe the comparability of results obtained by either the Abbott i-STAT® System POCT handheld device or the blood gases analyzer of the central laboratory of our hospital. Methods: Sample blood from 37 septic patients admitted to the intensive care unit (ICU) were assayed by Abbott i-STAT® System POCT and Radiometer ABL800 Flex® lab analyzer. Studied parameters were as follows: pH, pO2, pCO2, base excess (BE), HCO3- and lactate. Comparability was evaluated using Bland-Altman method. The clinical value for possible mismatch issued of values differences was also assessed. Results: Quite acceptable correlations in results of POCT and laboratory analyzer were observed with R² most of time above 0.85. Bland-Altman analysis showed a bias of 1.26% for Abbott i-STAT® System POCT vs laboratory. Conclusion: Abbott i-STAT® System POCT handheld device is comparable to Radiometer ABL800 Flex® lab analyzer and concordant with laboratory analysis. Abbott i-STAT® System POCT handled device could be used in the prehospital settings in order to evaluate the severity of sepsis.

Contexte: Les dispositifs médicaux de biologie délocalisée peuvent être utiles pour évaluer la gravité et aider au triage des patients à la fois en milieu hospitalier mais aussi en milieu préhospitalier. Avant leur utilisation, les performances analytiques de ces dispositifs médicaux doivent être comparées aux méthodes de référence des laboratoires hospitaliers. Dans cette étude, nous décrivons la comparabilité des résultats obtenus soit par le dispositif portable Abbott i-STAT® avec ceux fournis par l'analyseur de gaz du sang du laboratoire central de notre hôpital. Méthodes: Des échantillons de sang provenant de 37 patients septiques admis en réanimation ont été analysés par le système Abbott i-STAT® et l'analyseur de laboratoire Radiometer ABL800 Flex®. Les paramètres étudiés étaient les suivants : pH, pO2, pCO2, excès de base (BE), HCO3- et lactate. La comparabilité a été évaluée par la méthode de Bland-Altman. La valeur clinique de l'éventuelle inadéquation issue des différences de valeurs a également été évaluée. Résultats: Des corrélations tout à fait acceptables entre les résultats du système Abbott i-STAT® et de l'analyseur de laboratoire ont été observées, avec un R² le plus souvent supérieur à 0,85. L'analyse Bland-Altman a montré un biais de 1,26 % pour le système Abbott i-STAT® par rapport aux résultats fournis par l'analyseur du laboratoire. Conclusion: Le dispositif de biologie délocalisée Abbott i-STAT® est comparable et concordant avec l'analyseur de laboratoire Radiometer ABL800 Flex®. Le dispositif Abbott i-STAT® System POCT pourrait être utilisé en milieu préhospitalier afin d'évaluer la gravité de patients atteints de sepsis.