Skip to main content

Therapeutic Value of Blood Purification and Prognostic Utilities of Early Serum Procalcitonin, C Reactive Protein, and Brain Natriuretic Peptide Levels in Severely Burned Patients with Sepsis

Cell Biochemistry and Biophysics volume 72, pages 259–263 (2015)Cite this article

Abstract

The objective of this study was to evaluate therapeutic effectiveness of blood purification (BP) in severely burned patients with sepsis and to assess the prognostic utilities of early serum levels of procalcitonin (PCT), C reactive protein (CRP), brain natriuretic peptide (BNP). One hundred and ninety-five burn sepsis patients admitted in our hospital during May, 2008–May, 2014 were selected for the study and randomly divided into BP treatment (n = 98) and the control groups (n = 97). All of these patients received conventional therapy, while the BP group underwent additional BP treatment. Therapeutic effectiveness and survival rates of the two groups were compared 28 days after the treatment. The BP group was further divided into survivor and mortality groups, and the early serum levels of PCT, CRP, and BNP were compared retrospectively to analyze their relationship with prognosis. Acute physiology and chronic health evaluation and sequential organ failure assessment scores in the two groups were not significantly different before the treatment (p > 0.05). However, after the treatment, mortality in BP group (19.39 %) was significantly lower (p < 0.05) than that of the controls (27.84 %). Serum levels of PCT and CRP in the survivor and mortality groups were not significantly different (p > 0.05), whereas the serum BNP was significantly lower in the patients who survived than those who died (p < 0.05). The receiver-operating characteristic curve analysis further showed that predictive value of PCT and CRP for the burn sepsis prognosis was low (p > 0.05), however, that of the BNP was good (p < 0.05). The results obtained in this study indicate that BP treatment at an early stage can significantly improve the prognosis of burn sepsis. Furthermore, BNP, an important mediator involved in myocardial infarction and heart failure was found to be positively related with the severity of sepsis suggesting its reliable utility as prognostic indicator of sepsis. Thus, serum BNP monitored during the treatment may assist in adjusting the therapeutic strategies.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Luo, H., Li, X., & Cao, W. (2014). Advances in the research of effects of changes in immune function, coagulation function, and metabolism due to burn sepsis on wound healing. Zhonghua Shao Shang Za Zhi, 30(2), 137–140.

    PubMed  Google Scholar 

  2. Mattick, J. S., et al. (2013). Impact of burn priming on immune and metabolic functions of whole Liver in a rat cecal ligation and puncture model. The International Journal of Burns and Trauma, 3(1), 55–65.

    CAS  Google Scholar 

  3. Lucas, K., et al. (2012). Retinal laser burn-induced neuropathy leads to substance P-dependent loss of ocular immune privilege. The Journal of Immunology, 189(3), 1237–1242.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  4. Oncul, O., et al. (2014). Nosocomial infection characteristics in a burn intensive care unit: Nalysis of an eleven-year active surveillance. Burns, 40(5), 835–841.

    PubMed  Article  Google Scholar 

  5. Barajas-Nava, L. A., et al. (2013). Antibiotic prophylaxis for preventing burn wound infection. Cochrane Database of Systematic Reviews, 6, CD008738.

    PubMed  Google Scholar 

  6. Schultz, L., et al. (2013). Identification of predictors of early infection in acute burn patients. Burns, 39(7), 1355–1366.

    PubMed  Article  Google Scholar 

  7. Basu, A. (2011). Invasive burn wound infection. Indian Journal of Surgery, 73(4), 319–320.

    PubMed Central  PubMed  Article  Google Scholar 

  8. Nishimura, H., et al. (2014). Effects of blood purification therapy on a patient with ifosfamide-induced neurotoxicity and acute kidney injury. The Journal of Artificial Organs, 17(1), 110–113.

    Article  Google Scholar 

  9. Zhou, J. X., et al. (2013). Role of acute kidney injury staging by KDIGO criteria in choosing the opportune time of continuous blood purification. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 25(7), 420–423.

    PubMed  Google Scholar 

  10. Yue, R. Z., et al. (2012). Continuous blood purification therapy on 16 patients with diabetic ketoacidosis and acute kidney injury. Sichuan Da Xue Xue Bao Yi Xue Ban, 43(3), 434–437.

    PubMed  Google Scholar 

  11. Tang, W. X., et al. (2012). Combined blood purification for treating acute fatty liver of pregnancy complicated by acute kidney injury: a case series. The Journal of Artificial Organs, 15(2), 176–184.

    Article  Google Scholar 

  12. Hu, G., et al. (2014). Effects of blood purification in the treatment of patients with burn sepsis. Zhonghua Shao Shang Za Zhi, 30(3), 213–218.

    PubMed  Google Scholar 

  13. Peng, Z. Y., et al. (2013). Development of venovenous extracorporeal blood purification circuits in rodents for sepsis. Journal of Surgical Research, 185(2), 790–796.

    PubMed  Article  Google Scholar 

  14. Peng, Z. Y., et al. (2012). Acute removal of common sepsis mediators does not explain the effects of extracorporeal blood purification in experimental sepsis. Kidney International, 81(4), 363–369.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  15. Han, S. S., et al. (2011). Effect of continuous blood purification on endothelial cell function in patients with severe sepsis. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, 23(2), 81–84.

    CAS  PubMed  Google Scholar 

  16. Su, L., et al. (2013). Diagnostic value of dynamics serum sCD163, sTREM-1, PCT, and CRP in differentiating sepsis, severity assessment, and prognostic prediction. Mediators of Inflammation, 2013, 969875.

    PubMed Central  PubMed  Google Scholar 

  17. Hur, M., et al. (2014). Diagnostic and prognostic utilities of multimarkers approach using procalcitonin, B-type natriuretic peptide, and neutrophil gelatinase-associated lipocalin in critically ill patients with suspected sepsis. BMC Infectious Diseases, 14, 224.

    PubMed Central  PubMed  Article  Google Scholar 

  18. Sankar, V., & Webster, N. R. (2013). Clinical application of sepsis biomarkers. The Journal of Anesthesia, 27(2), 269–283.

    Article  Google Scholar 

  19. Zu, H., Li, Q., & Huang, P. (2014). Expression of treg subsets on intestinal T cell immunity and endotoxin translocation in porcine sepsis after severe burns. Cell Biochemistry and Biophysics, 70, 1699–1704.

    CAS  PubMed  Article  Google Scholar 

  20. Zhou, P., et al. (2014). Knockdown of Burton’s tyrosine kinase confers potent protection against sepsis-induced acute lung injury. Cell Biochemistry and Biophysics, 70(2), 1265–1275.

    CAS  PubMed  Article  Google Scholar 

  21. Serebruany, V.L., et al. (2013) Fatal sepsis and systemic inflammatory response syndrome after off-label prasugrel: A case report. American Journal Of Therapeutics.

  22. Shozushima, T., et al. (2011). Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome. The Journal of Infection and Chemotherapy, 17(6), 764–769.

    CAS  Article  Google Scholar 

  23. Haasper, C., et al. (2010). Prognostic value of procalcitonin (PCT) and/or interleukin-6 (IL-6) plasma levels after multiple trauma for the development of multi organ dysfunction syndrome (MODS) or sepsis. Technology and Health Care, 18(2), 89–100.

    CAS  PubMed  Google Scholar 

  24. Werdan, K., et al. (2009). Impaired regulation of cardiac function in sepsis, SIRS, and MODS. Canadian Journal of Physiology and Pharmacology, 87(4), 266–274.

    CAS  PubMed  Article  Google Scholar 

  25. Chai, J. K. (2013). Diagnosis and comprehensive management of sepsis after burn. Zhonghua Shao Shang Za Zhi, 29(2), 105–108.

    PubMed  Google Scholar 

  26. Yizhi, P., et al. (2013). Diagnostic criteria and treatment protocol for post-burn sepsis. Critical Care, 17(1), 406.

    PubMed Central  PubMed  Article  Google Scholar 

  27. Chai, J., Sheng, Z., & Yang, H. (1999). Treatment of invasive burn wound infection with sepsis: a clinical study. Zhonghua Yi Xue Za Zhi, 79(12), 908–910.

    CAS  PubMed  Google Scholar 

  28. Li, M. Q., et al. (2014). Efficacy of various combined blood purification techniques for treating patients with non-viral acute liver failure. Cell Biochemistry and Biophysics, 68(3), 571–575.

    CAS  PubMed  Article  Google Scholar 

  29. Cheng, J., et al. (2013). Comparison of the therapeutic effectiveness of sustained low-efficiency dialysis (SLED) with continuous blood purification (CBP) in critically ill patients. Cell Biochemistry and Biophysics, 67(3), 923–927.

    CAS  PubMed  Article  Google Scholar 

  30. Rimmele, T., & Kellum, J. A. (2011). Clinical review: Blood purification for sepsis. Critical Care, 15(1), 205.

    PubMed Central  PubMed  Article  Google Scholar 

  31. Yang, J., & Tian, Z. F. (2010). Effect of continuous blood purification on plasma cytokines in children with severe sepsis. Nan Fang Yi Ke Da Xue Xue Bao, 30(4), 921–923.

    PubMed  Google Scholar 

  32. Santaguida, P. L., et al. (2014). BNP and NT-proBNP as prognostic markers in persons with acute decompensated heart failure: A systematic review. Heart Failure Reviews, 19(4), 453–470.

    CAS  PubMed  Article  Google Scholar 

  33. McLean, A. S., & Huang, S. J. (2014). Brain not processing: is finding a role for BNP in sepsis like fitting a square peg into a round hole? Critical Care, 18(4), 161.

    PubMed  Article  Google Scholar 

  34. Li, N., et al. (2013). BNP and NT-proBNP levels in patients with sepsis. Frontiers in Bioscience (Landmark Edition), 18, 1237–1243.

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Burn, The First Affiliated Hospital of Henan University of Science and Technology, No 24, Jinghua Road, Jianxi District, Luoyang, 471003, Henan, China

    Hongxu Zu, Qinghua Li, Peixin Huang & Xiaorong Wang

Authors
  1. Hongxu Zu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Qinghua Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peixin Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiaorong Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xiaorong Wang.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zu, H., Li, Q., Huang, P. et al. Therapeutic Value of Blood Purification and Prognostic Utilities of Early Serum Procalcitonin, C Reactive Protein, and Brain Natriuretic Peptide Levels in Severely Burned Patients with Sepsis. Cell Biochem Biophys 72, 259–263 (2015). https://doi.org/10.1007/s12013-014-0446-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12013-014-0446-y

Keywords

  • Procalcitonin
  • C reactive protein
  • Brain natriuretic peptide
  • Blood purification
  • Burn sepsis prognosis