OBJECTIVE: To investigate whether endotoxin, interleukin-6, and circulating adhesion molecules, measured sequentially in blood, can predict mortality and organ dysfunction in sepsis. DESIGN: Inception cohort study with follow-up for 28 days. SETTING: Surgical intensive care unit at a university hospital. PATIENTS: A total of 14 consecutive patients were enrolled in the study within the first 24 hrs after onset of septic shock. Seven healthy subjects were studied as controls. INTERVENTIONS: Patients were analyzed for mortality and development of organ dysfunction. MEASUREMENTS AND MAIN RESULTS: At the end of the 28-day follow-up period, seven of the patients were still alive (survivors) but the other seven (nonsurvivors) had died. At the time of enrollment in the study (day 0), the Acute Physiology and Chronic Health Evaluation II score was 28.4 in survivors (n = 7) and 28.7 in nonsurvivors (n = 7). In contrast, circulating intercellular adhesion molecule-1 (ICAM-1) was significantly higher in nonsurvivors than in survivors. Circulating ICAM-1 predicted mortality in patients with septic shock with a sensitivity and a specificity of 71.4% each. Endotoxin, interleukin-6, circulating L-selectin, P-selectin, E-selectin, and platelet endothelial cell adhesion molecule-1, however, did not distinguish between survivors and nonsurvivors. In addition, circulating ICAM-1 at day 0 showed a significant correlation with the highest serum bilirubin observed during the entire study period (r2 = 0.963). CONCLUSIONS: Because only circulating ICAM-1 was higher in nonsurvivors than in survivors at day 0, circulating ICAM-1 may serve as an early prognostic marker for outcome in septic shock. In addition, measurement of circulating ICAM-1 facilitates identification of those patients with the highest risk of developing liver dysfunction.
OBJECTIVE: To investigate whether endotoxin, interleukin-6, and circulating adhesion molecules, measured sequentially in blood, can predict mortality and organ dysfunction in sepsis. DESIGN: Inception cohort study with follow-up for 28 days. SETTING: Surgical intensive care unit at a university hospital. PATIENTS: A total of 14 consecutive patients were enrolled in the study within the first 24 hrs after onset of septic shock. Seven healthy subjects were studied as controls. INTERVENTIONS:Patients were analyzed for mortality and development of organ dysfunction. MEASUREMENTS AND MAIN RESULTS: At the end of the 28-day follow-up period, seven of the patients were still alive (survivors) but the other seven (nonsurvivors) had died. At the time of enrollment in the study (day 0), the Acute Physiology and Chronic Health Evaluation II score was 28.4 in survivors (n = 7) and 28.7 in nonsurvivors (n = 7). In contrast, circulating intercellular adhesion molecule-1 (ICAM-1) was significantly higher in nonsurvivors than in survivors. Circulating ICAM-1 predicted mortality in patients with septic shock with a sensitivity and a specificity of 71.4% each. Endotoxin, interleukin-6, circulating L-selectin, P-selectin, E-selectin, and platelet endothelial cell adhesion molecule-1, however, did not distinguish between survivors and nonsurvivors. In addition, circulating ICAM-1 at day 0 showed a significant correlation with the highest serum bilirubin observed during the entire study period (r2 = 0.963). CONCLUSIONS: Because only circulating ICAM-1 was higher in nonsurvivors than in survivors at day 0, circulating ICAM-1 may serve as an early prognostic marker for outcome in septic shock. In addition, measurement of circulating ICAM-1 facilitates identification of those patients with the highest risk of developing liver dysfunction.
Authors: Thorsten Brenner; Claudia Rosenhagen; Jochen Steppan; Christoph Lichtenstern; Jürgen Weitz; Thomas Bruckner; Eike O Martin; Ursula Hoffmann; Markus A Weigand; Stefan Hofer Journal: Mediators Inflamm Date: 2010-08-05 Impact factor: 4.711
Authors: G C Beck; N Rafat; P Brinkkoetter; C Hanusch; J Schulte; M Haak; K van Ackern; F J van der Woude; B A Yard Journal: Clin Exp Immunol Date: 2006-03 Impact factor: 4.330
Authors: Felipe Dal-Pizzol; Cristiane Ritter; Omar J Cassol; Gislaine T Rezin; Fabrícia Petronilho; Alexandra I Zugno; João Quevedo; Emilio L Streck Journal: Neurochem Res Date: 2009-08-14 Impact factor: 3.996
Authors: Rens Zonneveld; Roberta Martinelli; Nathan I Shapiro; Taco W Kuijpers; Frans B Plötz; Christopher V Carman Journal: Crit Care Date: 2014-02-18 Impact factor: 9.097
Authors: Stefan Hofer; Thorsten Brenner; Christian Bopp; Jochen Steppan; Christoph Lichtenstern; Jürgen Weitz; Thomas Bruckner; Eike Martin; Ursula Hoffmann; Markus A Weigand Journal: Crit Care Date: 2009-06-18 Impact factor: 9.097