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Intensive Care Medicine

, 35:1859 | Cite as

Assessment of pro-vasopressin and pro-adrenomedullin as predictors of 28-day mortality in septic shock patients

  • Caroline Guignant
  • Nicolas Voirin
  • Fabienne Venet
  • Françoise Poitevin
  • Christophe Malcus
  • Julien Bohé
  • Alain Lepape
  • Guillaume MonneretEmail author
Original

Abstract

Purpose

Improvements in survival after septic shock will most likely rely on our capacity to manage individualized therapies based on the measurement of rapidly accessible biomarkers. As the early phase of septic shock is dominated by severe alterations of the cardiovascular system, the predictive value for mortality of pro-vasopressin (pro-AVP) and pro-adrenomedullin (pro-ADM), two vasoactive pro-hormones, was assessed.

Methods

In 99 consecutive patients, pro-hormone concentrations were measured (immunoluminometric assay) three times within the first week after the onset of septic shock.

Results

Pro-AVP and pro-ADM concentrations were significantly increased in non-survivors in comparison with survivors and were significantly associated with mortality after both univariate and multivariate analysis. Importantly, when assessed as a pair, pro-ADM and pro-AVP were even more informative.

Conclusions

Both Pro-ADM and pro-AVP appear to be good biomarkers for the prediction of 28-day mortality after septic shock. However, their association in a single variable tends to improve their predictive capacity.

Keywords

Septic shock Mortality Prognosis Adrenomedullin Vasopressin 

Notes

Acknowledgments

This work was supported by the Hospices Civils de Lyon and was conducted thanks to the support of Brahms—we especially thank Dr. N.G. Morgenthaler and Dr. A. Bergmann. All measurements were performed in the Research Department of Brahms AG in a totally blinded fashion without knowledge of clinical parameters. This work was also conducted thanks to the logistical support (H. Thizy, F. Gueyffier) from the Centre d’Investigation Clinique (CIC 201) de Lyon (Clinical Research Centre) of INSERM and Hospices Civils de Lyon.

Supplementary material

134_2009_1610_MOESM1_ESM.doc (90 kb)
Table S1 (DOC 90 kb)

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Caroline Guignant
    • 1
  • Nicolas Voirin
    • 2
  • Fabienne Venet
    • 1
  • Françoise Poitevin
    • 1
  • Christophe Malcus
    • 1
  • Julien Bohé
    • 3
  • Alain Lepape
    • 3
  • Guillaume Monneret
    • 1
    Email author
  1. 1.Flow Cytometry Unit, Immunology Laboratory, Hôpital E. Herriot, Hospices Civils de LyonLyon cedex 03France
  2. 2.INSERM U271, Hospices Civils de Lyon, Hôpital E. Herriot, Service d’Hygiène, Epidémiologie et PréventionUniversité de LyonLyonFrance
  3. 3.Intensive Care Units, Hospices Civils de Lyon, CH Lyon-SudLyonFrance

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