Jochen Gille1, Josephine Schmidt2, Thomas Kremer3, Armin Sablotzki2. 1. Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, St. Georg Hospital gGmbH Leipzig, Germany. Electronic address: Jochen.Gille@sanktgeorg.de. 2. Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, St. Georg Hospital gGmbH Leipzig, Germany. 3. Department of Plastic and Hand Surgery with burn care unit, St. Georg Hospital gGmbH Leipzig, Germany.
Abstract
PURPOSE: The significance of the validated biomarkers of sepsis Mid-regional pro-atrial natriuretic peptide (MR-proANP) and copeptin have not been tested in a burn injury setting. MATERIALS AND METHODS: 42 consecutive patients were included in a prospective observational study. Daily blood specimens collected over the initial 20 days of treatment were quantitatively analysed by immunoluminometric sandwich assay (Kryptor, BRAHMS, Berlin, Germany) for MR-proANP, copeptin and procalcitonin (PCT). RESULTS: In patients with absence of sepsis, copeptin levels initially increased post-burn injury and thereafter rapidly declined. In contrast, MR-proANP was only slightly elevated within the first few days. MR-proANP [199.8 (115.6; 399.5) vs 160.1 (93.7; 280.6), P < .007] and PCT [1.12 (0.32; 2.22) vs 0.32 (0.16; 0.53), P < .001] levels were significantly higher on days of sepsis. Copeptin, however, showed no significant differences [20.7 (11.8; 42.2) vs 16.8 (11.0; 30.6), P = .11]. Both, MR-proANP and PCT level increases were noted upon the first day of sepsis. CONCLUSION: Burn injury itself maybe associated with copeptin and to a lesser degree MR-proANP level increases. Subsequent increases in MR-proANP may be considered diagnostic for sepsis but demonstrated no advantages over PCT. The role of copeptin remains inappropriate for diagnosing sepsis after burn injury (ClinicalTrials.gov number, NCT01055587).
PURPOSE: The significance of the validated biomarkers of sepsis Mid-regional pro-atrial natriuretic peptide (MR-proANP) and copeptin have not been tested in a burn injury setting. MATERIALS AND METHODS: 42 consecutive patients were included in a prospective observational study. Daily blood specimens collected over the initial 20 days of treatment were quantitatively analysed by immunoluminometric sandwich assay (Kryptor, BRAHMS, Berlin, Germany) for MR-proANP, copeptin and procalcitonin (PCT). RESULTS: In patients with absence of sepsis, copeptin levels initially increased post-burn injury and thereafter rapidly declined. In contrast, MR-proANP was only slightly elevated within the first few days. MR-proANP [199.8 (115.6; 399.5) vs 160.1 (93.7; 280.6), P < .007] and PCT [1.12 (0.32; 2.22) vs 0.32 (0.16; 0.53), P < .001] levels were significantly higher on days of sepsis. Copeptin, however, showed no significant differences [20.7 (11.8; 42.2) vs 16.8 (11.0; 30.6), P = .11]. Both, MR-proANP and PCT level increases were noted upon the first day of sepsis. CONCLUSION:Burn injury itself maybe associated with copeptin and to a lesser degree MR-proANP level increases. Subsequent increases in MR-proANP may be considered diagnostic for sepsis but demonstrated no advantages over PCT. The role of copeptin remains inappropriate for diagnosing sepsis after burn injury (ClinicalTrials.gov number, NCT01055587).
Authors: Charalampos Pierrakos; Dimitrios Velissaris; Max Bisdorff; John C Marshall; Jean-Louis Vincent Journal: Crit Care Date: 2020-06-05 Impact factor: 9.097
Authors: Eray Yagmur; Johanna Hermine Sckaer; Ger H Koek; Ralf Weiskirchen; Christian Trautwein; Alexander Koch; Frank Tacke Journal: J Transl Med Date: 2019-12-12 Impact factor: 5.531