Abstract:
BACKGROUND:The use of novel sepsis biomarkers has increased in recent years. However, their prognostic value with respect to illness severity has not been explored. In this work, we examined the ability of mid-regional proadrenomedullin (MR-proADM) in predicting mortality in sepsis patients with different degrees of organ failure, compared to that of procalcitonin, C-reactive protein and lactate. METHODS:This was a two-centre prospective observational cohort, enrolling severe sepsis or septic shock patients admitted to the ICU. Plasma biomarkers were measured during the first 12 h of admission. The association between biomarkers and 28-day mortality was assessed by Cox regression analysis and Kaplan-Meier curves. Patients were divided into three groups as evaluated by the Sequential Organ Failure Assessment (SOFA) score. The accuracy of the biomarkers for mortality was determined by area under the receiver operating characteristic curve (AUROC) analysis. RESULTS:A total of 326 patients with severe sepsis (21.7%) or septic shock (79.3%) were enrolled with a 28-day mortality rate of 31.0%. Only MR-proADM and lactate were associated with mortality in the multivariate analysis: hazard ratio 8.5 versus 3.4 (p < 0.001). MR-proADM showed the best AUROC for mortality prediction at 28 days in the analysis over the entire cohort (AUROC [95% CI] 0.79 [0.74-0.84]) (p < 0.001). When patients were stratified by the degree of organ failure, MR-proADM was the only biomarker to predict mortality in all severity groups (SOFA ≤ 6, SOFA = 7-12, and SOFA ≥ 13), AUROC [95% CI] of 0.75 [0.61-0.88], 0.74 [0.66-0.83] and 0.73 [0.59-0.86], respectively (p < 0.05). All patients with MR-proADM concentrations ≤0.88 nmol/L survived up to 28 days. In patients with SOFA ≤ 6, the addition of MR-proADM to the SOFA score increased the ability of SOFA to identify non-survivors, AUROC [95% CI] 0.70 [0.58-0.82] and 0.77 [0.66-0.88], respectively (p < 0.05 for both). CONCLUSIONS:The performance of prognostic biomarkers in sepsis is highly influenced by disease severity. MR-proADM accuracy to predict mortality is not affected by the degree of organ failure. Thus, it is a good candidate in the early identification of sepsis patients with moderate disease severity but at risk of mortality.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
Andaluz-Ojeda D,Nguyen HB,Meunier-Beillard N,Cicuéndez R,Quenot JP,Calvo D,Dargent A,Zarca E,Andrés C,Nogales L,Eiros JM,Tamayo E,Gandía F,Bermejo-Martín JF,Charles PEdoi
10.1186/s13613-017-0238-9subject
Has Abstractpub_date
2017-12-01 00:00:00pages
15issue
1issn
2110-5820pii
10.1186/s13613-017-0238-9journal_volume
7pub_type
杂志文章abstract:INTRODUCTION:About 30% of patients with Guillain-Barré syndrome become ventilator dependent, of whom roughly 75% develop pneumonia. This trial aimed at assessing the impact of early mechanical ventilation (EMV) on pneumonia occurrence in GBS patients. We hypothesize that EMV will reduce the incidence of pneumonia. MET...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00742-z
更新日期:2020-09-30 00:00:00
abstract:BACKGROUND:Occlusion pressure at 100 ms (P0.1), defined as the negative pressure measured 100 ms after the initiation of an inspiratory effort performed against a closed respiratory circuit, has been shown to be well correlated with central respiratory drive and respiratory effort. Automated P0.1 measurement is availab...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0576-x
更新日期:2019-09-13 00:00:00
abstract:: Multiple experimental and human trials have shown that microcirculatory alterations are frequent in sepsis. In this review, we discuss the characteristics of these alterations, the various mechanisms potentially involved, and the implications for therapy. Sepsis-induced microvascular alterations are characterized by ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-1-27
更新日期:2011-07-19 00:00:00
abstract:BACKGROUND:While the process of sepsis-induced immunosuppression is now well described in adults, very little information is available on immune functions in pediatric sepsis. The current study investigated this in children with septic shock by performing immunomonitoring, including both innate (monocyte human leukocyt...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0382-x
更新日期:2018-03-13 00:00:00
abstract:BACKGROUND:We assessed the association of intravenous insulin and glucose infusion with intensive care unit (ICU) and hospital mortality. METHODS:For this retrospective association study, we used data from all patients admitted to a medical-surgical ICU between January 2012 and September 2017. We excluded patients adm...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0507-x
更新日期:2019-02-11 00:00:00
abstract:BACKGROUND:The echocardiography working group of the European Society of Intensive Care Medicine recognized the need to provide structured guidance for future CCE research methodology and reporting based on a systematic appraisal of the current literature. Here is reported this systematic appraisal. METHODS:We conduct...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-020-00662-y
更新日期:2020-04-25 00:00:00
abstract:BACKGROUND:Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxygen therapy (HFNT) might benefit patients with hypoxemia and can reduce physiological dead space. We hypothesized that HFNT and NIV would similarly reduce work of breathi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0432-4
更新日期:2018-09-05 00:00:00
abstract:BACKGROUND:Despite improvements in intermittent hemodialysis management, intradialytic hemodynamic instability (IHI) remains a common issue that could account for increased mortality and delayed renal recovery. However, predictive factors of IHI remain poorly explored. The objective of this study was to evaluate the re...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00663-x
更新日期:2020-04-22 00:00:00
abstract:BACKGROUND:cRel, a subunit of NF-κB, is implicated in the inflammatory response observed in autoimmune disease. Hence, knocked-out mice for cRel had a significantly higher mortality, providing new and important functions of cRel in the physiopathology of septic shock. Whether genetic variants in the human REL gene are ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0130-z
更新日期:2016-12-01 00:00:00
abstract::This review examines the available evidence for targeting a specific mean arterial pressure (MAP) in sepsis resuscitation. The clinical data suggest that targeting an MAP of 65-70 mmHg in patients with septic shock who do not have chronic hypertension is a reasonable first approximation. Whereas in patients with chron...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0085-5
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Optimal anti-bacterial activity of meropenem requires maintenance of its plasma concentration (Cp) above the minimum inhibitory concentration (MIC) of the pathogen for at least 40% of the dosing interval (fT > MIC > 40). We aimed to determine whether a 3-h extended infusion (EI) of meropenem achieves fT > MI...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0622-8
更新日期:2020-01-10 00:00:00
abstract:BACKGROUND:Preliminary reports have described significant procoagulant events in patients with coronavirus disease-2019 (COVID-19), including life-threatening pulmonary embolism (PE). MAIN TEXT:We review the current data on the epidemiology, the possible underlying pathophysiologic mechanisms, and the therapeutic impl...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-020-00741-0
更新日期:2020-09-16 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) occurs in up to 50% of all critically ill patients and hemodynamic abnormalities are assumed to contribute, but their nature and share is still unclear. We explored the associations between hemodynamic variables, including cardiac index and right ventricular function, and the occurr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0513-z
更新日期:2019-03-13 00:00:00
abstract::An amendment to this paper has been published and can be accessed via the original article. ...
journal_title:Annals of intensive care
pub_type: 已发布勘误
doi:10.1186/s13613-020-00691-7
更新日期:2020-06-02 00:00:00
abstract:BACKGROUND:Sepsis-associated acute kidney injury (SA-AKI) is an independent risk factor for death in patients with sepsis, but treatment for it is limited. To improve the diagnosis and treatment of SA-AKI, we must first understand its pathogenesis. Recently, interleukin (IL)-17A has been shown to be associated with the...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0157-1
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Acute respiratory distress syndrome (ARDS) patients may present impaired in lung function and structure after hospital discharge that may be related to mechanical ventilation strategy. The aim of this study was to evaluate the association between functional and structural lung impairment, N-terminal-peptide ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0469-4
更新日期:2018-12-07 00:00:00
abstract::The death of a loved one is often an ordeal and a tragedy for those who witness it, as death is not merely the end of a life, but also the end of an existence, the loss of a unique individual who is special and irreplaceable. In some situations, end-of-life signs, such as agonal gasps, can be an almost unbearable "sig...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/2110-5820-4-23
更新日期:2014-07-08 00:00:00
abstract:BACKGROUND:Hypoxic hepatitis (HH) is a type of acute hepatic injury that is histologically characterized by centrilobular liver cell necrosis and that is caused by insufficient oxygen delivery to the hepatocytes. Typical for HH is the sudden and significant increase of aspartate aminotransferase (AST) in response to ca...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0356-z
更新日期:2018-01-30 00:00:00
abstract::Pharmacological interventions are commonly considered in acute respiratory distress syndrome (ARDS) patients. Inhaled nitric oxide (iNO) and neuromuscular blockers (NMBs) are used in patients with severe hypoxemia. No outcome benefit has been observed with the systematic use of iNO. However, a sometimes important impr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-20
更新日期:2013-07-03 00:00:00
abstract:BACKGROUND AND AIMS:Data on outcome of critically ill children with cirrhosis are scarce. We aimed to evaluate the prognostic accuracy of sequential organs scoring systems in children with cirrhosis admitted to Paediatric Intensive Care Units (PICU). METHODS:We performed a multicentre retrospective analysis of childre...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00753-w
更新日期:2020-10-14 00:00:00
abstract:BACKGROUND:Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether spe...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0173-1
更新日期:2016-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 信件
doi:10.1186/s13613-020-00745-w
更新日期:2020-10-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-018-0418-2
更新日期:2018-06-20 00:00:00
abstract:Introduction:Acute respiratory failure is the main reason for admission to the intensive care unit (ICU) in HIV-infected adults. There is little data about the epidemiology of respiratory viruses in this population. Methods:HIV-infected adults admitted to two intensive care units over a 6-year period for an acute resp...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00738-9
更新日期:2020-09-14 00:00:00
abstract:BACKGROUND:During passive mechanical ventilation, the driving pressure of the respiratory system is an important mediator of ventilator-induced lung injury. Monitoring of driving pressure during assisted ventilation, similar to controlled ventilation, could be a tool to identify patients at risk of ventilator-induced l...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0477-4
更新日期:2019-01-03 00:00:00
abstract:BACKGROUND:We performed a meta-analysis of randomized controlled trials (RCTs) to determine if daily bathing with chlorhexidine decreased hospital-acquired BSIs in critically ill patients. METHODS:We searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases to identify randomized contr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0073-9
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Despite advances in supportive care, moderate-severe acute respiratory distress syndrome (ARDS) is associated with high mortality rates, and novel therapies to treat this condition are needed. Compelling pre-clinical data from mouse, rat, sheep and ex vivo perfused human lung models support the use of human ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-014-0022-z
更新日期:2014-07-03 00:00:00
abstract:UNLABELLED: BACKGROUND:A history of prolonged and excessive consumption of alcohol increases the risk for infections. The goal of this study was to investigate circulating white blood cells (WBC) differentiated by flow cytometry and neutrophil CD64 expression in excessive alcohol drinkers versus abstinent or moderate ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-50
更新日期:2012-12-31 00:00:00
abstract:BACKGROUND:Changeovers of norepinephrine infusion pumps (CNIPs) frequently lead to haemodynamic instability. The aim of this study was to identify risk factors for haemodynamic instability associated with CNIP, independent of the method used to perform the relay. METHODS:We performed a prospective study, in a universi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0139-3
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The effects of perioperative statin therapy on clinical outcome after cardiac or non-cardiac surgery are controversial. We aimed to assess the association between perioperative statin therapy and postoperative outcome. METHODS:Electronic databases were searched up to May 1, 2018, for randomized controlled t...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-018-0441-3
更新日期:2018-09-27 00:00:00