{"id":{"repo_id":"varna","oai_identifier":"oai:repository.mu-varna.bg:nls/4112"},"canonical_url":"https://search.dev.ndltd.org/etd/varna/oai:repository.mu-varna.bg:nls/4112","repository":{"repo_id":"varna","name":"Medical University of Varna","base_url":"https://repository.mu-varna.bg/oai/request"},"display":{"title":"Septic and Critical Conditions in Children Admitted to Intensive Care Unit. Clinical Profile, Early Diagnosis, and Prognosis // Септични и критични състояния при деца, лекувани в интензивно отделение: клиничен профил, ранна диагностика и прогноза","abstract":"Recognition of sepsis in children remains insufficiently studied and is a leading cause of mortality. This thesis examines the clinical profile and outcomes of paediatric patients with septic and critical conditions in the paediatric intensive care unit (PICU) and evaluates approaches for early diagnosis. The most affected age group is 13–48 months, with lower respiratory tract infections as the primary cause of sepsis, while intoxications predominate in non-infectious SIRS cases. The study found that over 40% of cases were microbiologically confirmed, with Escherichia coli, Streptococcus pneumoniae, and Staphylococcus aureus as the leading pathogens. A comparative analysis of prognostic scoring systems demonstrated that the Phoenix Sepsis Score outperforms PRISM III, PELOD-2, and pSOFA in sensitivity and specificity for predicting sepsis and associated complications. CRP and PCT remain key diagnostic markers, though their specificity is limited. Innovative biomarkers such as presepsin and sMR show potential for earlier disease recognition, but further research is required. Standardised protocols integrating microbiological and biochemical methods are needed to improve survival and reduce clinical deterioration in critically ill children. Future research should focus on developing and validating novel biomarkers that enhance existing diagnostic methods and enable more precise risk stratification.","abstract_html":"Recognition of sepsis in children remains insufficiently studied and is a leading cause of mortality. This thesis examines the clinical profile and outcomes of paediatric patients with septic and critical conditions in the paediatric intensive care unit (PICU) and evaluates approaches for early diagnosis. The most affected age group is 13–48 months, with lower respiratory tract infections as the primary cause of sepsis, while intoxications predominate in non-infectious SIRS cases. The study found that over 40% of cases were microbiologically confirmed, with Escherichia coli, Streptococcus pneumoniae, and Staphylococcus aureus as the leading pathogens. A comparative analysis of prognostic scoring systems demonstrated that the Phoenix Sepsis Score outperforms PRISM III, PELOD-2, and pSOFA in sensitivity and specificity for predicting sepsis and associated complications. CRP and PCT remain key diagnostic markers, though their specificity is limited. Innovative biomarkers such as presepsin and sMR show potential for earlier disease recognition, but further research is required. Standardised protocols integrating microbiological and biochemical methods are needed to improve survival and reduce clinical deterioration in critically ill children. Future research should focus on developing and validating novel biomarkers that enhance existing diagnostic methods and enable more precise risk stratification.","abstract_has_math":false,"creators":["Hadzhieva-Hristova, Adriana","Хаджиева-Христова, Адриана"],"institution":"Medical University of Varna","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-07-17T13:28:59Z","date_published":"2025-07-17T13:28:59Z","updated_at":"2026-07-27T21:56:49Z","subjects":["sepsis","paediatric intensive care unit","infections","clinical deterioration","Педиатрия / Paediatrics"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://repository.mu-varna.bg/handle/nls/4112","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Hadzhieva-Hristova, Adriana","Хаджиева-Христова, Адриана"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2025-07-17T13:28:59Z","2025"]},{"key":"dc:publisher","label":"Institution","values":["Medical University of Varna"]},{"key":"dc:type","label":"Dc Type","values":["thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["sepsis","paediatric intensive care unit","infections","clinical deterioration","Педиатрия / Paediatrics"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["http://repository.mu-varna.bg/handle/nls/4112"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Recognition of sepsis in children remains insufficiently studied and is a leading cause of mortality. This thesis examines the clinical profile and outcomes of paediatric patients with septic and critical conditions in the paediatric intensive care unit (PICU) and evaluates approaches for early diagnosis. The most affected age group is 13–48 months, with lower respiratory tract infections as the primary cause of sepsis, while intoxications predominate in non-infectious SIRS cases. The study found that over 40% of cases were microbiologically confirmed, with Escherichia coli, Streptococcus pneumoniae, and Staphylococcus aureus as the leading pathogens. A comparative analysis of prognostic scoring systems demonstrated that the Phoenix Sepsis Score outperforms PRISM III, PELOD-2, and pSOFA in sensitivity and specificity for predicting sepsis and associated complications. CRP and PCT remain key diagnostic markers, though their specificity is limited. Innovative biomarkers such as presepsin and sMR show potential for earlier disease recognition, but further research is required. Standardised protocols integrating microbiological and biochemical methods are needed to improve survival and reduce clinical deterioration in critically ill children. Future research should focus on developing and validating novel biomarkers that enhance existing diagnostic methods and enable more precise risk stratification.","Разпознаването на сепсиса при деца остава недостатъчно проучено и е водеща причина за смъртност. Настоящата дисертация изследва клиничният профил и изход при деца със септични и критични състояния в детско интензивно отделение и оценява подходите за тяхната ранна диагностика. Най-засегнатата възрастова група е 13–48 месеца, като основна причина за сепсис са инфекции на долните дихателни пътища, а при неинфекциозен SIRS – интоксикации. Изследването установява, че над 40% от случаите са микробиологично потвърдени, като Escherichia coli, Streptococcus pneumoniae и Staphylococcus aureus са водещи причинители. Сравнителният анализ на прогностичните скали показва, че Phoenix Sepsis Score превъзхожда PRISM III, PELOD-2 и pSOFA по отношение на чувствителност и специфичност в прогнозирането на сепсис и свързаните с него усложнения. CRP и PCT остават основни маркери в диагностиката на заболяването, но тяхната специфичност е ограничена. Иновативни биомаркери като presepsin и sMR показват потенциал за по-ранно разпознаване на заболяването, но изискват допълнително проучване. Необходими са стандартизирани протоколи, комбиниращи микробиологични и биохимични методи за подобряване на преживяемостта и намаляване на усложненията при критично болни деца. Бъдещите изследвания следва да се насочат към разработване и валидиране на нови биомаркери, които да надградят съществуващите методи и да осигурят по-точна стратификация на риска."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Septic and Critical Conditions in Children Admitted to Intensive Care Unit. Clinical Profile, Early Diagnosis, and Prognosis // Септични и критични състояния при деца, лекувани в интензивно отделение: клиничен профил, ранна диагностика и прогноза"]}]}],"canonical_facts":{"dc:creator":["Hadzhieva-Hristova, Adriana","Хаджиева-Христова, Адриана"],"dc:date":["2025-07-17T13:28:59Z","2025"],"dc:description":["Recognition of sepsis in children remains insufficiently studied and is a leading cause of mortality. This thesis examines the clinical profile and outcomes of paediatric patients with septic and critical conditions in the paediatric intensive care unit (PICU) and evaluates approaches for early diagnosis. The most affected age group is 13–48 months, with lower respiratory tract infections as the primary cause of sepsis, while intoxications predominate in non-infectious SIRS cases. The study found that over 40% of cases were microbiologically confirmed, with Escherichia coli, Streptococcus pneumoniae, and Staphylococcus aureus as the leading pathogens. A comparative analysis of prognostic scoring systems demonstrated that the Phoenix Sepsis Score outperforms PRISM III, PELOD-2, and pSOFA in sensitivity and specificity for predicting sepsis and associated complications. CRP and PCT remain key diagnostic markers, though their specificity is limited. Innovative biomarkers such as presepsin and sMR show potential for earlier disease recognition, but further research is required. Standardised protocols integrating microbiological and biochemical methods are needed to improve survival and reduce clinical deterioration in critically ill children. Future research should focus on developing and validating novel biomarkers that enhance existing diagnostic methods and enable more precise risk stratification.","Разпознаването на сепсиса при деца остава недостатъчно проучено и е водеща причина за смъртност. Настоящата дисертация изследва клиничният профил и изход при деца със септични и критични състояния в детско интензивно отделение и оценява подходите за тяхната ранна диагностика. Най-засегнатата възрастова група е 13–48 месеца, като основна причина за сепсис са инфекции на долните дихателни пътища, а при неинфекциозен SIRS – интоксикации. Изследването установява, че над 40% от случаите са микробиологично потвърдени, като Escherichia coli, Streptococcus pneumoniae и Staphylococcus aureus са водещи причинители. Сравнителният анализ на прогностичните скали показва, че Phoenix Sepsis Score превъзхожда PRISM III, PELOD-2 и pSOFA по отношение на чувствителност и специфичност в прогнозирането на сепсис и свързаните с него усложнения. CRP и PCT остават основни маркери в диагностиката на заболяването, но тяхната специфичност е ограничена. Иновативни биомаркери като presepsin и sMR показват потенциал за по-ранно разпознаване на заболяването, но изискват допълнително проучване. Необходими са стандартизирани протоколи, комбиниращи микробиологични и биохимични методи за подобряване на преживяемостта и намаляване на усложненията при критично болни деца. Бъдещите изследвания следва да се насочат към разработване и валидиране на нови биомаркери, които да надградят съществуващите методи и да осигурят по-точна стратификация на риска."],"dc:format":["application/pdf"],"dc:identifier":["http://repository.mu-varna.bg/handle/nls/4112"],"dc:publisher":["Medical University of Varna"],"dc:subject":["sepsis","paediatric intensive care unit","infections","clinical deterioration","Педиатрия / Paediatrics"],"dc:title":["Septic and Critical Conditions in Children Admitted to Intensive Care Unit. Clinical Profile, Early Diagnosis, and Prognosis // Септични и критични състояния при деца, лекувани в интензивно отделение: клиничен профил, ранна диагностика и прогноза"],"dc:type":["thesis"]},"updated_at":"2026-07-27T21:56:49Z"}