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Prognostic Markers in Sepsis

  • Conference paper
Yearbook of Intensive Care and Emergency Medicine 1998

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1998))

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Abstract

Sepsis remains one of the leading causes of death on the intensive care unit (ICU). Despite a greater understanding of the pathophysiologic state, there is still no specific treatment that has been proven to improve outcome. The increased awareness of the mechanisms behind the septic state, has led to an appreciation of a variety of factors that may either influence or be related to the severity of the illness or the eventual patient outcome. As these prognostic markers become better understood, new treatment strategies can be directed towards a “high risk” group of patients, who have the greatest potential for improvement. This paper attempts to discuss a variety of these factors which may influence, and/or be used to identify, outcome in sepsis.

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References

  1. Metrangolo L, Fiorillo M, Friedman G, et al (1995) Early hemodynamic course of septic shock. Crit Care Med 13: 1971–1975

    Article  Google Scholar 

  2. Parker MM, Shelhamer JH, Natanson C, Ailing DW, Parrillo JE (1987) Serial cardiovascular variables in survivors and nonsurvivors of human septic shock: heart rate as an early predictor of prognosis. Crit Care Med 15: 923–929

    Article  PubMed  CAS  Google Scholar 

  3. Hayes MA, Timmins AC, Yau EH, Palazzo M, Watson DH, Hinds CJ (1997) Oxygen transport patterns in patients with sepsis syndrome or septic shock: influence of treatment and relation-ship to outcome. Crit Care Med 25: 926–936

    Article  PubMed  CAS  Google Scholar 

  4. D’Orio V, Mendes P, Saad G, Marcelle R (1990) Accuracy in early prediction of prognosis of patients with septic shock by analysis of simple indices: prospective study. Crit Care Med 18: 1339–1345

    Article  PubMed  Google Scholar 

  5. Wray GM, Hinds CJ (1997) Determinants of outcome from sepsis and septic shock. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Springer-Verlag, Berlin, Heidelberg, New York, pp 168–179

    Google Scholar 

  6. Bihari D, Smithies M, Gimson A, Tinker J (1987) The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients. N Engl J Med 317: 397–403

    Article  PubMed  CAS  Google Scholar 

  7. Rhodes A, Malagon I, Lamb FJ, Newman PJ, Grounds RM, Bennett ED (1996) Failure to increase oxygen consumption is a predictor of mortality in septic patients. Intensive Care Med 22: S274 (Abst)

    Google Scholar 

  8. Vallet B, Chopin C, Curtis SE, et al (1993) Prognostic value of the dobutamine test in patients with sepsis syndrome and normal lactate values: a prospective, multicenter study. Crit Care Med 21: 1868–1875

    Article  PubMed  CAS  Google Scholar 

  9. Bishop MH, Shoemaker WC, Appel PL, et al (1995) Prospective, randomized trial of survivor values of cardiac index, oxygen delivery, and oxygen consumption as resuscitation endpoints in severe trauma. J Trauma 38: 780–787

    Article  PubMed  CAS  Google Scholar 

  10. Yu M, Levy MM, Smith P, Takiguchi SA, Miyasaki A, Myers SA (1993) Effect of maximizing oxygen delivery on morbidity and mortality rates in critically ill patients: a prospective, randomized, controlled study. Crit Care Med 21: 830–838

    Article  PubMed  CAS  Google Scholar 

  11. Boyd O, Grounds RM, Bennett ED (1993) A randomized clinical trial of the effect of deliberate perioperative increase of oxygen delivery on mortality in high-risk surgical patients. JAMA 270: 2699–2707

    Article  PubMed  CAS  Google Scholar 

  12. Rhodes A, Boyd O, Bland JM, Grounds RM, Bennett ED (1997) Routine blood gas analysis and gastric tonometry: a reappraisal. Lancet 350: 413–420

    Article  PubMed  CAS  Google Scholar 

  13. Maynard N, Bihari D, Beale R, et al (1993) Assessment of splanchnic oxygenation by gastric tonometry in patients with acute circulatory failure. JAMA 270: 1203–1210

    Article  PubMed  CAS  Google Scholar 

  14. Boyd O, Mackay CJ, Lamb G, Bland JM, Grounds RMB, Bennett ED (1993) Comparison of clinical information gained from routine blood-gas analysis and from gastric tonometry for intramural pH. Lancet 341: 142–146

    Article  PubMed  CAS  Google Scholar 

  15. Fiddian-Green RG, McGough E, Pittenger GR, Rothman E (1983) Predictive value of intramural pH and other risk factors for massive bleeding from stress ulceration. Gastroenterology 85: 613–620

    PubMed  CAS  Google Scholar 

  16. Fiddian-Green RG, Baker S (1987) Predictive value of the stomach wall pH for complications after cardiac operations: comparison with other monitoring. Crit Care Med 15: 153–156

    Article  PubMed  CAS  Google Scholar 

  17. Gutierrez G, Palizas F, Doglio G, et al (1992) Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet 339: 195–199

    Article  PubMed  CAS  Google Scholar 

  18. Gutierrez G, Bismar H, Dantzker DR, Silva N (1992) Comparison of gastric intramucosal pH with measures of oxygen transport and consumption in critically ill patients. Crit Care Med 20: 451–457

    Article  PubMed  CAS  Google Scholar 

  19. Gys T, Hubens A, Neels H, Lauwers LF, Peeters R (1988) Prognostic value of gastric intramural pH in surgical intensive care patients. Crit Care Med 16: 1222–1224

    Article  PubMed  CAS  Google Scholar 

  20. Gomersall CD, Joynt GM, Ho KM, Young RJ, Buckley TA, Oh TE (1997) Gastric tonometry and prediction of outcome in the critically ill. Arterial to intramucosal pH gradient and carbon dioxide gradient. Anaesthesia 52: 619–623

    Article  PubMed  CAS  Google Scholar 

  21. Joynt GM, Lipman J, Gomersall CD, Tan J, Scribante J (1997) Gastric intramucosal pH and blood lactate in severe sepsis. Anaesthesia 52: 726–732

    Article  PubMed  CAS  Google Scholar 

  22. Marik PE (1993) Gastric intramucosal pH. A better predictor of multiorgan dysfunction syn¬drome and death than oxygen-derived variables in patients with sepsis. Chest 104: 225–229

    Article  PubMed  CAS  Google Scholar 

  23. Sheeran P,Hall GM (1997) Cytokines in anaesthesia. Br J Anaesth 78: 201–219

    PubMed  CAS  Google Scholar 

  24. Pinsky MR, Vincent JL, Deviere J, Alegre M, Kahn RJD, Dupont E (1993) Serum cytokine levels in human septic shock. Relation to multiple-system organ failure and mortality. Chest 103: 565–575

    Article  PubMed  CAS  Google Scholar 

  25. Marano MA, Fong Y, Moldawer LL, et al (1990) Serum cachectin/tumor necrosis factor in critically ill patients with burns correlates with infection and mortality. Surg Gynecol Obst 170: 32–38

    CAS  Google Scholar 

  26. Girardin E, Grau GE, Dayer JM, Roux-Lombard P, Lambert PH (1988) Tumor necrosis factor and interleukin-1 in the serum of children with severe infectious purpura. N Engl J Med 319: 397–400

    Article  PubMed  CAS  Google Scholar 

  27. Waage A, Halstensen A, Espevik T (1987) Association between tumour necrosis factor in serum and fatal outcome in patients with meningococcal disease. Lancet 1: 355–357

    Article  PubMed  CAS  Google Scholar 

  28. Martin C, Saux P, Mege JL, Perrin G, Papazian L, Gouin F (1994) Prognostic values of serum cytokines in septic shock. Intensive Care Med 20: 272–277

    Article  PubMed  CAS  Google Scholar 

  29. Friedland JS, Porter JC, Daryanani S, et al (1996) Plasma proinflammatory cytokine concentrations, Acute Physiology and Chronic Health Evaluation (APACHE) III scores and survival in patients in an intensive care unit. Crit Care Med 24: 1775–1781

    Article  PubMed  CAS  Google Scholar 

  30. Beutler B, Grau GE (1993) Tumor necrosis factor in the pathogenesis of infectious diseases. Crit Care Med 21: S423–S435

    Article  PubMed  CAS  Google Scholar 

  31. Strieter RM, Kunkel SL,Bone RC (1993) Role of tumor necrosis factor-alpha in disease states and inflammation.. Crit Care Med 21: S447–S463

    Google Scholar 

  32. Blackwell TS,Christman JW (1996) Sepsis and cytokines: current status. Br Anaesth 77: 110–117

    CAS  Google Scholar 

  33. Dinarello CA (1991) Interleukin-1 and interleukin-1 antagonism. Blood 77: 1627–1652

    PubMed  CAS  Google Scholar 

  34. Goldie AS, Fearon KC, Ross JA, et al (1995) Natural cytokine antagonists and endogenous anti- endotoxin core antibodies in sepsis syndrome. The Sepsis Intervention Group. JAMA 274: 172–177

    Article  PubMed  CAS  Google Scholar 

  35. McAllister SK, Bland LA, Arduino MJ, Aguero SM, Wenger PN, Jarvis WR (1994) Patient cytokine response in transfusion-associated sepsis. Infect Immun 62: 2126–2128

    PubMed  CAS  Google Scholar 

  36. Casey LC, Balk RA, Bone RC (1993) Plasma cytokine and endotoxin levels correlate with sur¬vival in patients with the sepsis syndrome. Ann Intern Med 119: 771–778

    PubMed  CAS  Google Scholar 

  37. Moscovitz H, Shofer F, Mignott H, Behrman A, Kilpatrick L (1994) Plasma cytokine determinations in emergency department patients as a predictor of bacteremia and infectious disease severity. Crit Care Med 22: 1102–1107

    Article  PubMed  CAS  Google Scholar 

  38. Damas P, Ledoux D, Nys M, Vrindts Y, De Groote DF, Lamy M (1992) Cytokine serum level during severe sepsis in human: IL-6 as a marker of severity. Ann Surg 215: 356–362

    Article  PubMed  CAS  Google Scholar 

  39. Marecaux G, Pinsky MR, Dupont E, Kahn RJ, Vincent JL (1996) Blood lactate levels are better prognostic indicators than TNF and IL-6 levels in patients with septic shock. Intensive Care Med 22: 404–408

    Article  PubMed  CAS  Google Scholar 

  40. Hack CE, Hart M, van Schijndel RJ, et al (1992) Interleukin-8 in sepsis: relation to shock and inflammatory mediators. Infect Immun 60: 2835–2842

    PubMed  CAS  Google Scholar 

  41. Gudgeon AM, Patel G, Hermon-Taylor JH, Bowyer RC, Jehanli AM (1991) Detection of human pancreatic pro-phospholipase A2 activation using an immunoassay for the free activation peptide DSGISPR. Ann Clin Biochem 28: 497–503

    PubMed  CAS  Google Scholar 

  42. Rae D, Sumar N, Beechey-Newman N, Gudgeon MH (1995) Type 1-prophospholipase A2 propeptide immunoreactivity is released from activated granulocytes. Clin Biochem 28: 71–78

    Article  PubMed  CAS  Google Scholar 

  43. Rae D, Porter J, Beechey-Newman N, Sumar N, Bennett D, Hermon-Taylor J (1994) Type 1-pro- phospholipase A2 propeptide in acute lung injury. Lancet 344: 1472–1473

    Article  PubMed  CAS  Google Scholar 

  44. Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohuon C (1993) High serum procalci- tonin concentrations in patients with sepsis and infection. Lancet 341: 515–518

    Article  PubMed  CAS  Google Scholar 

  45. Gendrel D, Assicot M, Raymond J, et al (1996) Procalcitonin as a marker for the early diagnosis of neonatal infection. J Pediatrics 128: 570–573

    Article  CAS  Google Scholar 

  46. Monneret G, Labaune JM, Isaac C, Bienvenu F, Putet G, Bienvenu J (1997) Procalcitonin and C-reactive protein levels in neonatal infections. Acta Paediatrica 86: 209–212

    Article  PubMed  CAS  Google Scholar 

  47. Kuse ER, Langefeld I, Jaeger J, et al (1997) Procalcitonin differentiates infection and rejection after solid organ transplantation. Intensive Care Med 23 (suppl 1): S62 (Abst)

    Google Scholar 

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Authors
  1. A. Rhodes
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  2. P. J. Newman
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  3. E. D. Bennett
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Editor information

Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Clinical Director) (Clinical Director)

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© 1998 Springer-Verlag Berlin Heidelberg

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Rhodes, A., Newman, P.J., Bennett, E.D. (1998). Prognostic Markers in Sepsis. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1998. Yearbook of Intensive Care and Emergency Medicine, vol 1998. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72038-3_21

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  • DOI: https://doi.org/10.1007/978-3-642-72038-3_21

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-63798-1

  • Online ISBN: 978-3-642-72038-3

  • eBook Packages: Springer Book Archive

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