N-terminal pro-brain natriuretic peptide as an early prognostic factor in cancer patients developing septic shock.

Abstract:

INTRODUCTION:The overall prognosis of critically ill patients with cancer has improved during the past decade. The aim of this study was to identify early prognostic factors of intensive care unit (ICU) mortality in patients with cancer. METHODS:We designed a prospective, consecutive, observational study over a one-year period. Fifty-one cancer patients with septic shock were enrolled. RESULTS:The ICU mortality rate was 51% (26 deaths). Among the 45 patients who benefited from transthoracic echocardiography evaluation, 17 showed right ventricular dysfunction, 18 showed left ventricular diastolic dysfunction, 18 showed left ventricular systolic dysfunction, and 11 did not show any cardiac dysfunction. During the first three days of ICU course, N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were significantly higher in patients presenting cardiac dysfunctions compared to patients without any cardiac dysfunction. Multivariate analysis discriminated early prognostic factors (within the first 24 hours after the septic shock diagnosis). ICU mortality was independently associated with NT-proBNP levels at day 2 (odds ratio, 1.2; 95% confidence interval, 1.004 to 1.32; p = 0.022). An NT-proBNP level of more than 6,624 pg/ml predicted ICU mortality with a sensitivity of 86%, a specificity of 77%, a positive predictive value of 79%, a negative predictive value of 85%, and an accuracy of 81%. CONCLUSION:We observed that critically ill cancer patients with septic shock have an approximately 50% chance of survival to ICU discharge. NT-proBNP was independently associated with ICU mortality within the first 24 hours. NT-proBNP could be a useful tool for detecting high-risk cancer patients within the first 24 hours after septic shock diagnosis.

journal_name

Crit Care

authors

Mokart D,Sannini A,Brun JP,Faucher M,Blaise D,Blache JL,Faucher C

doi

10.1186/cc5721

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

R37

issue

2

eissn

1364-8535

issn

1466-609X

pii

cc5721

journal_volume

11

pub_type

杂志文章
  • Therapeutic Potential of the Gut Microbiota in the Management of Sepsis.

    abstract::This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2020. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2020. Further information about the Annual Update in Intensive Care and Emergency Medicine is available ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-020-2780-3

    authors: Bassetti M,Bandera A,Gori A

    更新日期:2020-03-24 00:00:00

  • Circulating bioactive adrenomedullin as a marker of sepsis, septic shock and critical illness.

    abstract:BACKGROUND:Biomarkers can be of help to understand critical illness and to identify and stratify sepsis. Adrenomedullin is a vasoactive hormone, with reported prognostic and potentially therapeutic value in sepsis. The primary aim of this study was to investigate the association of circulating bioactive adrenomedullin ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03351-1

    authors: Lundberg OHM,Lengquist M,Spångfors M,Annborn M,Bergmann D,Schulte J,Levin H,Melander O,Frigyesi A,Friberg H

    更新日期:2020-11-04 00:00:00

  • Impact of antibacterials on subsequent resistance and clinical outcomes in adult patients with viral pneumonia: an opportunity for stewardship.

    abstract:INTRODUCTION:Respiratory viruses are increasingly recognized as significant etiologies of pneumonia among hospitalized patients. Advanced technologies using multiplex molecular assays and polymerase-chain reaction increase the ability to identify viral pathogens and may ultimately impact antibacterial use. METHOD:This...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-1120-5

    authors: Crotty MP,Meyers S,Hampton N,Bledsoe S,Ritchie DJ,Buller RS,Storch GA,Kollef MH,Micek ST

    更新日期:2015-11-18 00:00:00

  • Mild hypoglycemia is independently associated with increased mortality in the critically ill.

    abstract:INTRODUCTION:Severe hypoglycemia (blood glucose concentration (BG) < 40 mg/dL) is independently associated with an increased risk of mortality in critically ill patients. The association of milder hypoglycemia (BG < 70 mg/dL) with mortality is less clear. METHODS:Prospectively collected data from two observational coh...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc10322

    authors: Krinsley JS,Schultz MJ,Spronk PE,Harmsen RE,van Braam Houckgeest F,van der Sluijs JP,Mélot C,Preiser JC

    更新日期:2011-07-25 00:00:00

  • The role of intestinal mucosa injury induced by intra-abdominal hypertension in the development of abdominal compartment syndrome and multiple organ dysfunction syndrome.

    abstract:INTRODUCTION:Abdominal distension is common in critical illness. There is a growing recognition that intra-abdominal hypertension (IAH) may complicate nonsurgical critical illness as well as after abdominal surgery. However, the pathophysiological basis of the injury to the intestinal mucosal barrier and its influence ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13146

    authors: Cheng J,Wei Z,Liu X,Li X,Yuan Z,Zheng J,Chen X,Xiao G,Li X

    更新日期:2013-12-09 00:00:00

  • Dexmedetomidine sedation reduces atrial fibrillation after cardiac surgery compared to propofol: a randomized controlled trial.

    abstract:BACKGROUND:Atrial fibrillation occurs frequently in patients following cardiac surgery and can be a cause of increased morbidity and mortality. The use of dexmedetomidine to prevent atrial fibrillation is unclear. The present study was designed to evaluate the effect of dexmedetomidine sedation on the incidence of atri...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1480-5

    authors: Liu X,Zhang K,Wang W,Xie G,Fang X

    更新日期:2016-09-21 00:00:00

  • Targeting the programmed cell death 1: programmed cell death ligand 1 pathway reverses T cell exhaustion in patients with sepsis.

    abstract:INTRODUCTION:A major pathophysiologic mechanism in sepsis is impaired host immunity which results in failure to eradicate invading pathogens and increased susceptibility to secondary infections. Although many immunosuppressive mechanisms exist, increased expression of the inhibitory receptor programmed cell death 1 (PD...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13176

    authors: Chang K,Svabek C,Vazquez-Guillamet C,Sato B,Rasche D,Wilson S,Robbins P,Ulbrandt N,Suzich J,Green J,Patera AC,Blair W,Krishnan S,Hotchkiss R

    更新日期:2014-01-04 00:00:00

  • New versus old blood - the debate continues.

    abstract::Since the inception of blood banking, refinements in laboratory processes have allowed for progressively longer storage times of red blood cells. Whilst advantageous for the logistics of stock management, the clinical impact of the duration of red blood cell storage prior to transfusion remains uncertain, and a topic ...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc8878

    authors: Laurie J,Wyncoll D,Harrison C

    更新日期:2010-01-01 00:00:00

  • Whole blood thromboelastometry: another Knight at the Roundtable?

    abstract::Thromboelastography and thromboelastometry represent viscoelastic diagnostic methodologies with promising application to diseases of altered coagulation. Their use in trauma-induced coagulopathy as a means of assessing the real-time status of the patient's functional coagulation profile in addition to its impact on ef...

    journal_title:Critical care (London, England)

    pub_type: 评论,社论

    doi:10.1186/cc10569

    authors: Bluth MH,Kashuk JL

    更新日期:2011-01-01 00:00:00

  • Using an expiratory resistor, arterial pulse pressure variations predict fluid responsiveness during spontaneous breathing: an experimental porcine study.

    abstract:INTRODUCTION:Fluid responsiveness prediction is difficult in spontaneously breathing patients. Because the swings in intrathoracic pressure are minor during spontaneous breathing, dynamic parameters like pulse pressure variation (PPV) and systolic pressure variation (SPV) are usually small. We hypothesized that during ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7760

    authors: Dahl MK,Vistisen ST,Koefoed-Nielsen J,Larsson A

    更新日期:2009-01-01 00:00:00

  • Muscle regeneration after sepsis.

    abstract::Severe critical illness is often complicated by intensive care unit-acquired weakness (ICU-AW), which is associated with increased ICU and post-ICU mortality, delayed weaning from mechanical ventilation and long-term functional disability. Several mechanisms have been implicated in the pathophysiology of ICU-AW, but m...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1308-3

    authors: Bouglé A,Rocheteau P,Sharshar T,Chrétien F

    更新日期:2016-05-19 00:00:00

  • Community-acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis.

    abstract:INTRODUCTION:The frequency and clinical significance of polymicrobial aetiology in community-acquired pneumonia (CAP) patients admitted to the ICU have been poorly studied. The aim of the present study was to describe the prevalence, clinical characteristics and outcomes of severe CAP of polymicrobial aetiology in pati...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc10444

    authors: Cillóniz C,Ewig S,Ferrer M,Polverino E,Gabarrús A,Puig de la Bellacasa J,Mensa J,Torres A

    更新日期:2011-01-01 00:00:00

  • A systematic review of randomized controlled trials exploring the effect of immunomodulative interventions on infection, organ failure, and mortality in trauma patients.

    abstract:INTRODUCTION:Following trauma, patients may suffer an overwhelming pro-inflammatory response and immune paralysis resulting in infection and multiple organ failure (MOF). Various potentially immunomodulative interventions have been tested. The objective of this study is to systematically review the randomized controlle...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc9218

    authors: Spruijt NE,Visser T,Leenen LP

    更新日期:2010-01-01 00:00:00

  • Reliability of standard pupillometry practice in neurocritical care: an observational, double-blinded study.

    abstract:BACKGROUND:In critical care units, pupil examination is an important clinical parameter for patient monitoring. Current practice is to use a penlight to observe the pupillary light reflex. The result seems to be a subjective measurement, with low precision and reproducibility. Several quantitative pupillometer devices ...

    journal_title:Critical care (London, England)

    pub_type: 临床试验,杂志文章

    doi:10.1186/s13054-016-1239-z

    authors: Couret D,Boumaza D,Grisotto C,Triglia T,Pellegrini L,Ocquidant P,Bruder NJ,Velly LJ

    更新日期:2016-03-13 00:00:00

  • Induction of Bim and Bid gene expression during accelerated apoptosis in severe sepsis.

    abstract:INTRODUCTION:In transgenic animal models of sepsis, members of the Bcl-2 family of proteins regulate lymphocyte apoptosis and survival of sepsis. This study investigates the gene regulation of pro-apoptotic and anti-apoptotic members of the Bcl-2 family of proteins in patients with early stage severe sepsis. METHODS:I...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7088

    authors: Weber SU,Schewe JC,Lehmann LE,Müller S,Book M,Klaschik S,Hoeft A,Stüber F

    更新日期:2008-01-01 00:00:00

  • Glycaemic control targets after traumatic brain injury: a systematic review and meta-analysis.

    abstract:BACKGROUND:Optimal glycaemic targets in traumatic brain injury (TBI) remain unclear. We performed a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing intensive with conventional glycaemic control in TBI requiring admission to an intensive care unit (ICU). METHODS:We systematically se...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1186/s13054-017-1883-y

    authors: Hermanides J,Plummer MP,Finnis M,Deane AM,Coles JP,Menon DK

    更新日期:2018-01-19 00:00:00

  • Statistics review 4: sample size calculations.

    abstract::The present review introduces the notion of statistical power and the hazard of under-powered studies. The problem of how to calculate an ideal sample size is also discussed within the context of factors that affect power, and specific methods for the calculation of sample size are presented for two common scenarios, ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc1521

    authors: Whitley E,Ball J

    更新日期:2002-08-01 00:00:00

  • Alveolar microstrain and the dark side of the lung.

    abstract::Mechanical ventilation associated lung injury (VALI) negatively impacts the outcomes of critically ill patients. Research during the past two decades has led to a better understanding of key physiologic mechanisms of injury, yet uncertainty over the topographical distribution of these mechanisms continues to fuel cont...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章,评审

    doi:10.1186/cc6160

    authors: Oeckler RA,Hubmayr RD

    更新日期:2007-01-01 00:00:00

  • Early mobilisation in intensive care units in Australia and Scotland: a prospective, observational cohort study examining mobilisation practises and barriers.

    abstract:INTRODUCTION:Mobilisation of patients in the intensive care unit (ICU) is an area of growing research. Currently, there is little data on baseline mobilisation practises and the barriers to them for patients of all admission diagnoses. METHODS:The objectives of the study were to (1) quantify and benchmark baseline lev...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-015-1033-3

    authors: Harrold ME,Salisbury LG,Webb SA,Allison GT,Australia and Scotland ICU Physiotherapy Collaboration.

    更新日期:2015-09-14 00:00:00

  • Impact of timing of renal replacement therapy initiation on outcome of septic acute kidney injury.

    abstract:INTRODUCTION:Sepsis is the leading cause of acute kidney injury (AKI) in critical patients. The optimal timing of initiating renal replacement therapy (RRT) in septic AKI patients remains controversial. The objective of this study is to determine the impact of early or late initiation of RRT, as defined using the simpl...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc10252

    authors: Chou YH,Huang TM,Wu VC,Wang CY,Shiao CC,Lai CF,Tsai HB,Chao CT,Young GH,Wang WJ,Kao TW,Lin SL,Han YY,Chou A,Lin TH,Yang YW,Chen YM,Tsai PR,Lin YF,Huang JW,Chiang WC,Chou NK,Ko WJ,Wu KD,Tsai TJ,NSARF Stud

    更新日期:2011-01-01 00:00:00

  • Biomarkers of lung epithelial injury and inflammation distinguish severe sepsis patients with acute respiratory distress syndrome.

    abstract:INTRODUCTION:Despite recent modifications, the clinical definition of the acute respiratory distress syndrome (ARDS) remains non-specific, leading to under-diagnosis and under-treatment. This study was designed to test the hypothesis that a biomarker panel would be useful for biologic confirmation of the clinical diagn...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13080

    authors: Ware LB,Koyama T,Zhao Z,Janz DR,Wickersham N,Bernard GR,May AK,Calfee CS,Matthay MA

    更新日期:2013-10-24 00:00:00

  • Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial).

    abstract:BACKGROUND:The timing of initiation of renal replacement therapy (RRT) in severe acute kidney injury (AKI) remains controversial, with early initiation resulting in unnecessary therapy for some patients while expectant therapy may delay RRT for other patients. The furosemide stress test (FST) has been shown to predict ...

    journal_title:Critical care (London, England)

    pub_type: 临床试验,杂志文章

    doi:10.1186/s13054-018-2021-1

    authors: Lumlertgul N,Peerapornratana S,Trakarnvanich T,Pongsittisak W,Surasit K,Chuasuwan A,Tankee P,Tiranathanagul K,Praditpornsilpa K,Tungsanga K,Eiam-Ong S,Kellum JA,Srisawat N,FST Study Group.

    更新日期:2018-04-19 00:00:00

  • Mechanical ventilation in rural ICUs.

    abstract::BACKGROUND: In recent years, rural hospitals have expanded their scope of specialized services, which has led to the development and staffing of rural intensive care units (ICUs). There is little information about the breadth, quality or outcomes of these services. This is particularly true for specialized ICU service...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc303

    authors: Fieselmann JF,Bock MJ,Hendryx MS,Wakefield D,Helms CM,Bentler SE

    更新日期:1999-01-01 00:00:00

  • Impact of HIV/AIDS on care and outcomes of severe sepsis.

    abstract:INTRODUCTION:There has been dramatic improvement in survival for patients with HIV/AIDS; however, some studies on patients with HIV/AIDS and serious illness have reported continued low rates of intensive care. The purpose of this study was to examine patterns of care and outcomes for patients with severe sepsis and HIV...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3811

    authors: Mrus JM,Braun L,Yi MS,Linde-Zwirble WT,Johnston JA

    更新日期:2005-01-01 00:00:00

  • The incretin effect in critically ill patients: a case-control study.

    abstract:INTRODUCTION:Patients admitted to the intensive care unit often develop hyperglycaemia, but the underlying mechanisms have not been fully described. The incretin effect is reduced in patients with type 2 diabetes. Type 2 diabetes and critical illness have phenotypical similarities, such as hyperglycaemia, insulin resis...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-1118-z

    authors: Nielsen ST,Janum S,Krogh-Madsen R,Solomon TP,Møller K

    更新日期:2015-11-16 00:00:00

  • Vasopressin improves outcome in out-of-hospital cardiopulmonary resuscitation of ventricular fibrillation and pulseless ventricular tachycardia: a observational cohort study.

    abstract:INTRODUCTION:An increasing body of evidence from laboratory and clinical studies suggests that vasopressin may represent a promising alternative vasopressor for use during cardiac arrest and resuscitation. Current guidelines for cardiopulmonary resuscitation recommend the use of adrenaline (epinephrine), with vasopress...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3967

    authors: Grmec S,Mally S

    更新日期:2006-02-01 00:00:00

  • Long-term survival of chronic dialysis patients following survival from an episode of multiple-organ failure.

    abstract:INTRODUCTION:This study aimed to examine the long-term outcome for patients with end-stage renal failure (ESRF) who survived multiple-organ failure. METHODS:We performed a review of databases from the renal medicine service and intensive care units (ICU) of the participating hospitals within Imperial College Healthcar...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7867

    authors: Chapman RJ,Templeton M,Ashworth S,Broomhead R,McLean A,Brett SJ

    更新日期:2009-01-01 00:00:00

  • The effect of diabetes mellitus on organ dysfunction with sepsis: an epidemiological study.

    abstract:INTRODUCTION:Diabetes mellitus (DM) is one of the most common chronic co-morbid medical conditions in the USA and is frequently present in patients with sepsis. Previous studies reported that people with DM and severe sepsis are less likely to develop acute lung injury (ALI). We sought to determine whether organ dysfun...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7717

    authors: Esper AM,Moss M,Martin GS

    更新日期:2009-01-01 00:00:00

  • Intensive care unit delirium is an independent predictor of longer hospital stay: a prospective analysis of 261 non-ventilated patients.

    abstract:INTRODUCTION:Delirium occurs in most ventilated patients and is independently associated with more deaths, longer stay, and higher cost. Guidelines recommend monitoring of delirium in all intensive care unit (ICU) patients, though few data exist in non-ventilated patients. The study objective was to determine the relat...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3729

    authors: Thomason JW,Shintani A,Peterson JF,Pun BT,Jackson JC,Ely EW

    更新日期:2005-08-01 00:00:00

  • Value of arterial blood gas analysis in patients with acute dyspnea: an observational study.

    abstract:INTRODUCTION:The diagnostic and prognostic value of arterial blood gas analysis (ABGA) parameters in unselected patients presenting with acute dyspnea to the Emergency Department (ED) is largely unknown. METHODS:We performed a post-hoc analysis of two different prospective studies to investigate the diagnostic and pro...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc10268

    authors: Burri E,Potocki M,Drexler B,Schuetz P,Mebazaa A,Ahlfeld U,Balmelli C,Heinisch C,Noveanu M,Breidthardt T,Schaub N,Reichlin T,Mueller C

    更新日期:2011-01-01 00:00:00