ArticleIntensive care medicine2003
Gender-based differences in children with sepsis and ARDS: the ESPNIC ARDS Database Group.
Article in Intensive care medicine, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 72 citations in OpenAlex.
- CALIPSO: A Randomized Controlled Trial of Calfactant for Acute Lung Injury in Pediatric Stem Cell and Oncology Patients.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2018Trial
- From Survival to Recovery: 25 Years of Paediatric Critical Care Transformation in Israel.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- Biological sex impacts immune cell proportions and epigenetic profiles in the developing pediatric immune system.Communications biology · 2025Article
- SEX DIFFERENCES IN SEPSIS-RELATED ACUTE RESPIRATORY DISTRESS SYNDROME AND OTHER SHORT-TERM OUTCOMES AMONG CRITICALLY ILL PATIENTS WITH SEPSIS: A RETROSPECTIVE STUDY IN CHINA.Shock (Augusta, Ga.) · 2025Observational
- Sex and gender differences in intensive care medicine.Intensive care medicine · 2023Review
- Case Fatality of Hospitalized Patients with COVID-19 Infection Suffering from Acute Respiratory Distress Syndrome in Germany.Viruses · 2022Article
- Circulating Endothelial Progenitor Cells Are Preserved in Female Mice Exposed to Ambient Fine Particulate Matter Independent of Estrogen.International journal of molecular sciences · 2021Article
- Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps.Critical care (London, England) · 2021Article
- Article
- Definition and global epidemiology of pediatric acute respiratory distress syndrome.Annals of translational medicine · 2019Review
- Plasma concentrations of secretory leukocyte protease inhibitor (SLPI) differ depending on etiology and severity in community-onset bloodstream infection.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2019Article
- Acute respiratory distress syndrome.Nature reviews. Disease primers · 2019Review
- The Number of X Chromosomes Influences Inflammatory Cytokine Production Following Toll-Like Receptor Stimulation.Frontiers in immunology · 2019Article
- Prevalence and Management of Septic Shock among Children Admitted at the Kenyatta National Hospital, Longitudinal Survey.International journal of pediatrics · 2019Article
- Sexual dimorphism in bacterial infections.Biology of sex differences · 2018Review
- Article
- Effects of perinatal testosterone on infant health, mother-infant interactions, and infant development.Biological research for nursing · 2014Article
- Differential regulation of cell death programs in males and females by Poly (ADP-Ribose) Polymerase-1 and 17β estradiol.Cell death & disease · 2013Article
- Gender differences in inflammatory processes could explain poorer prognosis for males.Journal of clinical microbiology · 2011Article
- The epidemiology of acute respiratory distress syndrome in pediatric intensive care units in China.Intensive care medicine · 2009Article
Corrections and comments
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Authors and funding
21 authors at 12 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Male gender predisposes to severe sepsis and septic shock. This effect has been ascribed to higher levels of testosterone. The ESPNIC ARDS database was searched, to determine if there was evidence of a similar male preponderance in severe sepsis in prepubertal patients in spite of low levels of male sex hormones at this age. A total of 72 patients beyond neonatal age up to 8 years of age with sepsis were identified. The male/female (M/F) ratio was 1.7 (1.0;2.7) and differed significantly from non-septic ARDS patients in this age group [n = 209; M/F = 1.0 (0.8;1.3)]. The highest M/F-ratio was observed in the first year of life. The gender-ratio was the same as reported in adult patients with sepsis. In infants between 1 month and 12 months of age, the ratio was 2.8 (1.2;6.1) (Chi2= 5.6; P< 0.01), in children from 1 year to 8 years of age it was 1.2 (0.7;2.2) (n.s.). In a subgroup of patients with severe sepsis or septic shock, caused by other bacteria than Neisseria meningitidis, the M/F-ratio was 2.1 (1.2;3.6) (Chi2= 4.9; P<0.05), while in patients with meningococcal sepsis (n=20) the M/F-ratio was 1.0 (0.4;2.3). In prepubertal ARDS patients with sepsis an increased frequency of male patients is found, comparable to adults. No male preponderance exists in patients with ARDS due to meningococcal septic shock. Since levels of testosterone and other sex hormones are extremely low at this age, we conclude that factors others than testosterone are involved in the male preponderance in severe sepsis.
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