Outcomes were 28-day mortality and differences in tumor necrosis factor-alpha (TNF-α) levels, hospital-acquired infection (HAI), and pediatric sequential organ failure assessment score (pSOFA) at seven days of randomization.<h4>Results</h4>Of 78 children, 25 (32%), 50 (64.1%), and 3 (3.8%) were discharged, died, and left against medical advice (LAMA), respectively. Here, TNF is linked to nosocomial infection.