High-mobility group box 1 protein plasma concentrations during septic shock
To investigate plasma high-mobility group box 1 protein (HMGB1) concentration and its relationship with organ dysfunction and outcome in septic shock patients.
Design and setting
Prospective, noninterventional study. Medical adult intensive care unit at a university hospital in France.
42 critically ill patients with septic shock.
Arterial blood was drawn within 12 h of admission for the measurement of plasma HMGB1 concentration by ELISA. Repeated sampling was performed on days 3, 7, and 14.
Median HMGB1 concentration was 4.4 ng/ml (IQR 1.2–12.5) at admission, with no difference between survivors and nonsurvivors. A positive correlation was observed between HMGB1 and SOFA score and lactate, and procalcitonin concentrations. There was a progressive but statistically nonsignificant decline in HMGB1 concentration among the survivors, while nonsurvivors showed an increase in HMGB1 level between days 1 and 3. SOFA score and lactate and procalcitonin concentrations did not vary significantly between days 1 and 3. When measured on day 3, HMGB1 discriminated survivors from nonsurvivors with 66% sensitivity and 67% specificity, and concentration greater than 4 ng/ml was associated with an odds ratio of death of 5.5 (95% CI 1.3–23.6).
KeywordsSeptic shock HMGB1 Prognosis
S.G. designed the study, enrolled patients, performed measurements, and drafted the manuscript; F.M. performed measurements; A.C., D.B., and L.N. enrolled patients; P.E.B. designed the study and drafted the manuscript. All authors approved the final version of the manuscript
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