A parameters and/or ICU scoring systems has not been completely
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A parameters and/or ICU scoring systems has not been completely established, nor if levels of circulating extracellular histones can be used as predictive markers for clinical outcome in sepsis. Methods: Histone H3 (H3) plasma levels of 43 sepsis patients who were admitted to the Intensive Care Unit were measured and we determined the correlation of H3 levels with disease severity, organ failure, mortality and coagulation- and tissue homeostasis parameters including LDH levels, thrombin potential (ETP), prothrombin levels, antithrombin levels and platelet counts. Results: For sepsis patients at the ICU we found that median H3 levels were significantly increased in non-survivors as compared to survivors with levels found being 3.15 g/ml versus 0.57 g/ml respectively, P = 0.04. H3 levels are positively correlated with lactate dehydrogenase (LDH) activity (Spearman's rho = 0.49, P < 0.001), and negatively correlated with antithrombin levels (rho = -0.34, P = 0.027) and platelet counts (rho = -0.33, P = 0.031). Conclusions: We conclude that circulating H3 levels correlate with mortality in sepsis patients and inversely correlate with antithrombin levels and platelet counts. P018 Il-8: is this a more reliable biomarker for sepsis severity than CRP, Procalcitonin, E-selectin, IL-6 and TNF-[alpha] S. Pillai, G. Davies, G. Mills, R. Aubrey, K. PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/12711626 Morris, P. Williams, P. Evans NISCHR Haemostasis Biomarker Research Unit, Swansea, UK Critical Care 2016, 20(Suppl 2):P018 Introduction: Sepsis is a systemic inflammatory response syndrome (SIRS) with an evidence of infection. Numerous inflammatory markers have been studied to assess the severity of sepsis. However, current biomarkers are insufficient to accurately determine stage and prognosis [1]. This study aimed to assess the cytokine Interleukin-8 (IL-8) for determining the stage and severity of sepsis. A comparison was made with C-reactive protein (CRP), Procalcitonin (PCT), E-selectin, Interleukin-6 (IL-6) and Tumour Necrosis Factor- (TNF- ). Methods: This study had full ethical approval from the South West Wales Research Ethics Committee. Patients with a diagnosis of sepsis were recruited from the Emergency Department and Intensive Care Unit of a large teaching hospital in South ROCK-IN-2 Wales. Blood samples were taken to determine IL-8, CRP, PCT, E-selectin, IL-6 and TNF-. Results: 65 patients were included in the study: 40 with sepsis, 13 with severe PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/8627573 sepsis and 12 with septic shock. PCT concentration was significantly increased in subjects with septic shock when compared to sepsis (Table 3,*p = 0.001, Kruskal-Wallis test). IL-8 concentration was significantly increased in septic shock compared to both sepsis and severe sepsis groups (Table 3, **p < 0.001 and p = 0.013 respectively, Kruskal-Wallis test). Using ROC analysis, IL-8 was found to be a significant predictor of mortality (AUC 0.92, p < 0.001). Conclusions: Both IL-8 and PCT significantly distinguished septic shock from sepsis and severe sepsis. IL-8 was shown to be a promising inflammatory marker for assessing the severity and prognostication in patients across the sepsis spectrum.Reference 1. Pierrakos C Vincent JL. Crit Care. 2010;14:R15.Table 3 (Abstract P018). Inflammatory markers in different sepsis groups.Sepsis (n = 40) IL-8 (pg/mL) CRP (mg/dL) PCT (pg/mL) 61 (21, 176) 79 (40, 222) 308 (108, 1038) Severe Sepsis (n = 13) 71 (41, 104) 193 (124, 422) 702 (385, 1637) Septic Shock (n = 12) 526 (136, 7998)** 128 (21, 179) 1258 (230, 17296)**.