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 (bio-ADM) levels at intensive care unit (ICU) admission with mortality in sepsis patients and in a general ICU population. Secondary aims included the association of bio-ADM with organ failure and the ability of bio-ADM to identify sepsis. METHODS:In this retrospective observational study, adult patients admitted to one of four ICUs during 2016 had admission bio-ADM levels analysed. Age-adjusted odds ratios (OR) with 95% CI for log-2 transformed bio-ADM, and Youden's index derived cut-offs were calculated. The primary outcome was 30-day mortality, and secondary outcomes included the need for organ support and the ability to identify sepsis. RESULTS:Bio-ADM in 1867 consecutive patients were analysed; 632 patients fulfilled the sepsis-3 criteria of whom 267 had septic shock. The median bio-ADM in the entire ICU population was 40 pg/mL, 74 pg/mL in sepsis patients, 107 pg/mL in septic shock and 29 pg/mL in non-septic patients. The association of elevated bio-ADM and mortality in sepsis patients and the ICU population resulted in ORs of 1.23 (95% CI 1.07-1.41) and 1.22 (95% CI 1.12-1.32), respectively. The association with mortality remained after additional adjustment for lactate in sepsis patients. Elevated bio-ADM was associated with an increased need for dialysis with ORs of 2.28 (95% CI 2.01-2.59) and 1.97 (95% CI 1.64-2.36) for the ICU population and sepsis patients, respectively, and with increased need of vasopressors, OR 1.33 (95% CI 1.23-1.42) (95% CI 1.17-1.50) for both populations. Sepsis was identified with an OR of 1.78 (95% CI 1.64-1.94) for bio-ADM, after additional adjustment for severity of disease. A bio-ADM cut-off of 70 pg/mL differentiated between survivors and non-survivors in sepsis, but a Youden's index derived threshold of 108 pg/mL performed better. CONCLUSIONS:Admission bio-ADM is associated with 30-day mortality and organ failure in sepsis patients as well as in a general ICU population. Bio-ADM may be a morbidity-independent sepsis biomarker.

journal_name

Crit Care

authors

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

doi

10.1186/s13054-020-03351-1

subject

Has Abstract

pub_date

2020-11-04 00:00:00

pages

636

issue

1

eissn

1364-8535

issn

1466-609X

pii

10.1186/s13054-020-03351-1

journal_volume

24

pub_type

杂志文章
  • Does anesthetic provide similar neuroprotection to therapeutic hypothermia after cardiac arrest?

    abstract::In the previous issue of Critical Care, Meybohm and colleagues provide evidence to support hypothermia as a kind of therapeutic option for patients suffering cardiac arrest. Although anesthetics had been used to induce hypothermia, sevoflurane post-conditioning fails to confer additional anti-inflammatory effects afte...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc8923

    authors: Zhang H

    更新日期:2010-01-01 00:00:00

  • Searching for an ideal hemodynamic marker to predict short-term outcome in cardiogenic shock.

    abstract::Cardiogenic shock is a lethal condition. Physicians are searching for hemodynamic markers which could help risk-stratification of patients in this picture. Torgersen and coworkers present an hourly time integral of the cardiac power index and cardiac index drops to predict outcomes in the setting of cardiogenic shock....

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc8176

    authors: Yilmaz MB,Mebazaa A

    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

  • A week seems to be weak: tailoring duration of antibiotic treatment in Gram-negative ventilator-associated pneumonia.

    abstract::The optimal length of antimicrobial therapy has not been extensively studied for a great majority of infections and, in critically ill patients affected by ventilator-associated pneumonia, is a persisting and unsolved issue confronting clinicians. The integration of biomarkers, clinical judgment, and microbiologic era...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc11899

    authors: Martin-Loeches I,Torres A

    更新日期:2013-01-21 00:00:00

  • Intensive care unit acquired muscle weakness: when should we consider rehabilitation?

    abstract::Muscle weakness is highly prevalent during acute critical illness, with the poor exercise performance that occurs after critical illness being recognized as a consequence of skeletal muscles weakness. Advanced techniques to measure peripheral muscle strength are available, but they have limited use in the clinical set...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc7937

    authors: Puthucheary Z,Hart N

    更新日期:2009-01-01 00:00:00

  • Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock.

    abstract:BACKGROUND:This study aimed to investigate the feasibility of optical coherence tomography angiography (OCT-A) for quantitative analysis of flow density to assess changes in retinal perfusion in an experimental model of haemorrhagic shock. METHODS:Haemorrhagic shock was induced in five healthy, anaesthetized sheep by ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-018-2056-3

    authors: Alnawaiseh M,Ertmer C,Seidel L,Arnemann PH,Lahme L,Kampmeier TG,Rehberg SW,Heiduschka P,Eter N,Hessler M

    更新日期:2018-05-29 00:00:00

  • A systematic review of biomarkers multivariately associated with acute respiratory distress syndrome development and mortality.

    abstract:BACKGROUND:Heterogeneity of acute respiratory distress syndrome (ARDS) could be reduced by identification of biomarker-based phenotypes. The set of ARDS biomarkers to prospectively define these phenotypes remains to be established. OBJECTIVE:To provide an overview of the biomarkers that were multivariately associated ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-02913-7

    authors: van der Zee P,Rietdijk W,Somhorst P,Endeman H,Gommers D

    更新日期:2020-05-24 00:00:00

  • Re-tooling critical care to become a better intensivist: something old and something new.

    abstract::Developments in recent years have placed powerful new tools of diagnosis, therapy, and communication at the disposal of medicine in general, and of critical care in particular. The art of healing requires not only technical proficiency, but also personal connection, multidisciplinary teamwork, and commitment to the ve...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc14721

    authors: Marini JJ

    更新日期:2015-01-01 00:00:00

  • Causes of metabolic acidosis in canine hemorrhagic shock: role of unmeasured ions.

    abstract:INTRODUCTION:Metabolic acidosis during hemorrhagic shock is common and conventionally considered to be due to hyperlactatemia. There is increasing awareness, however, that other nonlactate, unmeasured anions contribute to this type of acidosis. METHODS:Eleven anesthetized dogs were hemorrhaged to a mean arterial press...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc6200

    authors: Bruegger D,Kemming GI,Jacob M,Meisner FG,Wojtczyk CJ,Packert KB,Keipert PE,Faithfull NS,Habler OP,Becker BF,Rehm M

    更新日期:2007-01-01 00:00:00

  • Use of machine learning to analyse routinely collected intensive care unit data: a systematic review.

    abstract:BACKGROUND:Intensive care units (ICUs) face financial, bed management, and staffing constraints. Detailed data covering all aspects of patients' journeys into and through intensive care are now collected and stored in electronic health records: machine learning has been used to analyse such data in order to provide dec...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-019-2564-9

    authors: Shillan D,Sterne JAC,Champneys A,Gibbison B

    更新日期:2019-08-22 00:00:00

  • High mixed venous oxygen saturation levels do not exclude fluid responsiveness in critically ill septic patients.

    abstract:INTRODUCTION:The aim of this study was to determine whether the degree of fluid responsiveness in critically ill septic patients is related to baseline mixed venous oxygen saturation (SvO2) levels. We also sought to define whether fluid responsiveness would be less likely in the presence of a high SvO2 (>70%). METHODS...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc10326

    authors: Velissaris D,Pierrakos C,Scolletta S,De Backer D,Vincent JL

    更新日期:2011-07-26 00:00:00

  • 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-ye...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc5721

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

    更新日期:2007-01-01 00:00:00

  • Provision of ECPR during COVID-19: evidence, equity, and ethical dilemmas.

    abstract::The use of extracorporeal cardiopulmonary resuscitation (ECPR) to restore circulation during cardiac arrest is a time-critical, resource-intensive intervention of unproven efficacy. The current COVID-19 pandemic has brought additional complexity and significant barriers to the ongoing provision and implementation of E...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03172-2

    authors: Worku E,Gill D,Brodie D,Lorusso R,Combes A,Shekar K

    更新日期:2020-07-27 00:00:00

  • In vivo validation of the adequacy calculator for continuous renal replacement therapies.

    abstract:INTRODUCTION:The study was conducted to validate in vivo the Adequacy Calculator, a Microsoft Excel-based program, designed to assess the prescription and delivery of renal replacement therapy in the critical care setting. METHODS:The design was a prospective cohort study, set in two intensive care units of teaching h...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc3517

    authors: Ricci Z,Salvatori G,Bonello M,Pisitkun T,Bolgan I,D'Amico G,Dan M,Piccinni P,Ronco C

    更新日期:2005-06-01 00:00:00

  • Early use of imipenem/cilastatin and vancomycin followed by de-escalation versus conventional antimicrobials without de-escalation for patients with hospital-acquired pneumonia in a medical ICU: a randomized clinical trial.

    abstract:INTRODUCTION:Although early use of broad-spectrum antimicrobials in critically ill patients may increase antimicrobial adequacy, uncontrolled use of these agents may select for more-resistant organisms. This study investigated the effects of early use of broad-spectrum antimicrobials in critically ill patients with hos...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc11197

    authors: Kim JW,Chung J,Choi SH,Jang HJ,Hong SB,Lim CM,Koh Y

    更新日期:2012-02-15 00:00:00

  • The Swiss bus accident on 13 March 2012: lessons for pre-hospital care.

    abstract::The recent bus crash in Switzerland involving many children provides several lessons for the pre-hospital care community. The use of multiple helicopters that are capable of flying at night and that carry advanced medical pre-hospital teams undoubtedly saved lives following the tragedy. We describe the medical respons...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc11370

    authors: Lyon RM,Sanders J

    更新日期:2012-07-11 00:00:00

  • Association between hospital volume and network membership and an analgesia, sedation and delirium order set quality score: a cohort study.

    abstract:INTRODUCTION:Protocols for the delivery of analgesia, sedation and delirium care of the critically ill, mechanically ventilated patient have been shown to improve outcomes but are not uniformly used. The extent to which elements of analgesia, sedation and delirium guidelines are incorporated into order sets at hospital...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc11390

    authors: Dale CR,Hayden SJ,Treggiari MM,Curtis JR,Seymour CW,Yanez ND 3rd,Fan VS

    更新日期:2012-06-18 00:00:00

  • Is acute respiratory distress syndrome an iatrogenic disease?

    abstract::In this month's issue of Critical Care, Determann and colleagues report the results of a randomized controlled trial comparing the effects of mechanical ventilation (MV) with two tidal volumes (6 versus 10 ml/kg predicted body weight) on cytokine levels in lung lavage fluid and plasma as a surrogate for early identifi...

    journal_title:Critical care (London, England)

    pub_type: 社论

    doi:10.1186/cc8842

    authors: Villar J,Slutsky AS

    更新日期:2010-01-01 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

  • Bench-to-bedside review: Immunoglobulin therapy for sepsis - biological plausibility from a critical care perspective.

    abstract::Sepsis represents a dysregulated host response to infection, the extent of which determines the severity of organ dysfunction and subsequent outcome. All trialled immunomodulatory strategies to date have resulted in either outright failure or inconsistent degrees of success. Intravenous immunoglobulin (IVIg) therapy f...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc10597

    authors: Shankar-Hari M,Spencer J,Sewell WA,Rowan KM,Singer M

    更新日期:2012-12-12 00:00:00

  • Standardisation of data collection in traumatic brain injury: key to the future?

    abstract::Great variability exists in data collection and coding of variables in studies on traumatic brain injury (TBI). This confounds comparison of results and analysis of data across studies. The difficulties in performing a meta-analysis of individual patient data were recently illustrated in the IMPACT project (Internatio...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc8163

    authors: Maas AI

    更新日期:2009-01-01 00:00:00

  • Simvastatin for patients with acute respiratory distress syndrome: long-term outcomes and cost-effectiveness from a randomised controlled trial.

    abstract:BACKGROUND:Simvastatin therapy for patients with acute respiratory distress syndrome (ARDS) has been shown to be safe and associated with minimal adverse effects, but it does not improve clinical outcomes. The aim of this research was to report on mortality and cost-effectiveness of simvastatin in patients with ARDS at...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1186/s13054-017-1695-0

    authors: Agus A,Hulme C,Verghis RM,McDowell C,Jackson C,O'Kane CM,Laffey JG,McAuley DF

    更新日期:2017-05-17 00:00:00

  • Early goal-directed resuscitation of patients with septic shock: current evidence and future directions.

    abstract::Severe sepsis and septic shock are among the leading causes of mortality in the intensive care unit. Over a decade ago, early goal-directed therapy (EGDT) emerged as a novel approach for reducing sepsis mortality and was incorporated into guidelines published by the international Surviving Sepsis Campaign. In addition...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-015-1011-9

    authors: Gupta RG,Hartigan SM,Kashiouris MG,Sessler CN,Bearman GM

    更新日期:2015-08-28 00:00:00

  • Success and complications by team composition for prehospital paediatric intubation: a systematic review and meta-analysis.

    abstract:BACKGROUND:Clinical team composition for prehospital paediatric intubation may affect success and complication rates. We performed a systematic review and meta-analysis to determine the success and complication rates by type of clinical team. METHODS:We searched MEDLINE, EMBASE, and CINAHL for interventional and obser...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,meta分析

    doi:10.1186/s13054-020-02865-y

    authors: Garner AA,Bennett N,Weatherall A,Lee A

    更新日期:2020-04-15 00:00:00

  • Year in review 2013: Critical Care--sepsis.

    abstract::This review presents key publications from the research field of sepsis published in Critical Care and other relevant journals during 2013. The results of these experimental studies and clinical trials are discussed in the context of current scientific and clinical background. The discussion highlights and summarises ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-014-0578-x

    authors: de Montmollin E,Annane D

    更新日期:2014-10-15 00:00:00

  • Long-term risk of sepsis among survivors of acute kidney injury.

    abstract::Many prior studies have shown that, in critically ill patients, acute kidney injury (AKI) commonly occurs in association with sepsis and its presence portends an increased likelihood of poor outcomes. In contrast, few studies have focused specifically on the influence of AKI on the long-term risk of developing sepsis....

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc13708

    authors: Clark E,Bagshaw SM

    更新日期:2014-01-24 00:00:00

  • Prehospital identification of trauma patients with early acute coagulopathy and massive bleeding: results of a prospective non-interventional clinical trial evaluating the Trauma Induced Coagulopathy Clinical Score (TICCS).

    abstract:INTRODUCTION:Identifying patients who need damage control resuscitation (DCR) early after trauma is pivotal for adequate management of their critical condition. Several trauma-scoring systems have been developed to identify such patients, but most of them are not simple enough to be used in prehospital settings in the ...

    journal_title:Critical care (London, England)

    pub_type: 临床试验,杂志文章

    doi:10.1186/s13054-014-0648-0

    authors: Tonglet ML,Minon JM,Seidel L,Poplavsky JL,Vergnion M

    更新日期:2014-11-26 00:00:00

  • Association of inflammatory biomarkers with subsequent clinical course in suspected late onset sepsis in preterm neonates.

    abstract:BACKGROUND:Sepsis is a major health issue in preterm infants. Biomarkers are used to diagnose and monitor patients with sepsis, but C-reactive protein (CRP) is proven not predictive at onset of late onset neonatal sepsis (LONS) diagnosis. The aim of this study was to evaluate the association of interleukin-6(IL-6), pro...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03423-2

    authors: Kurul Ş,Simons SHP,Ramakers CRB,De Rijke YB,Kornelisse RF,Reiss IKM,Taal HR

    更新日期:2021-01-06 00:00:00

  • Effect of glomerular filtration rate impairment on diagnostic performance of neutrophil gelatinase-associated lipocalin and B-type natriuretic peptide as markers of acute cardiac and renal failure in chronic kidney disease patients.

    abstract:INTRODUCTION:Cardio-renal syndromes are characterized by the impairment of cardiac and renal functions. Plasma and urinary neutrophil gelatinase-associated lipocalin (NGAL), and plasma B-type natriuretic peptide (BNP) are markers of acute kidney injury (AKI) and heart failure (HF), respectively. METHODS:GFR (99mTc-DTP...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13752

    authors: Donadio C

    更新日期:2014-02-28 00:00:00

  • Inflammation-induced hepcidin-25 is associated with the development of anemia in septic patients: an observational study.

    abstract:INTRODUCTION:Anemia is a frequently encountered problem during inflammation. Hepcidin is an interleukin-6 (IL-6)-induced key modulator of inflammation-associated anemia. Human sepsis is a prototypical inflammatory syndrome, often complicated by the development of anemia. However, the association between inflammation, h...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc9408

    authors: van Eijk LT,Kroot JJ,Tromp M,van der Hoeven JG,Swinkels DW,Pickkers P

    更新日期:2011-01-01 00:00:00