Early prolonged neutrophil activation in critically ill patients with sepsis

We hypothesised that plasma concentrations of biomarkers of neutrophil activation and pro-inflammatory cytokines differ according to the phase of rapidly evolving sepsis. In an observational study, we measured heparin-binding protein (HBP), myeloperoxidase (MPO), IL-6 and IL-8 in 167 sepsis patients on intensive care unit admission. We prospectively used the emergence of the first sepsis-associated organ dysfunction (OD) as a surrogate for the sepsis phase. Fifty-five patients (of 167, 33%) developed the first OD > 1 h before, 74 (44%) within ± 1 h, and 38 (23%) > 1 h after intensive care unit admission. HBP and MPO were elevated at a median of 12 h before the first OD, remained high up to 24 h, and were not associated with sepsis phase. IL-6 and IL-8 rose and declined rapidly close to OD emergence. Elevation of neutrophil activation markers HBP and MPO was an early event in the evolution of sepsis, lasting beyond the subsidence of the pro-inflammatory cytokine reaction. Thus, as sepsis biomarkers, HBP and MPO were not as prone as IL-6 and IL-8 to the effect of sample timing.

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Selected Biomarkers Correlate with the Origin and Severity of Sepsis

Mediators of Inflammation ◽

10.1155/2018/7028267 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 10

Author(s):

Michal Holub ◽

Olga Džupová ◽

Michaela Růžková ◽

Alžběta Stráníková ◽

Eva Bartáková ◽

...

Keyword(s):

Intensive Care Unit ◽

Plasma Levels ◽

Plasma Concentrations ◽

Community Acquired Pneumonia ◽

Heparin Binding ◽

Soluble Cd14 ◽

Gram Negative ◽

Heparin Binding Protein ◽

Microbial Etiology ◽

Time Point

The microbial etiology and source of sepsis influence the inflammatory response. Therefore, the plasma levels of cytokines (IL-6, IL-8, and IL-10), chemokines (CCL2/MCP-1, MIP-1β), heparin-binding protein (HBP), soluble CD14 (sCD14), and cortisol were analyzed in blood from septic patients obtained during the first 96 hours of intensive care unit hospitalization. The etiology was established in 56 out of a total of 62 patients enrolled in the study. Plasma concentrations of MCP-1, sCD14, IL-6, and IL-10 were significantly higher in patients with community-acquired pneumonia (CAP;n=10) and infective endocarditis (IE;n=11) compared to those with bacterial meningitis (BM;n=18). Next, cortisol levels were higher in IE patients than in those with BM and CAP, and at one time point, cortisol was also higher in patients with gram-negative sepsis when compared to those with gram-positive infections. Furthermore, cortisol and MCP-1 levels correlated positively with the daily measured SOFA score. In addition, HBP levels were significantly higher in patients with IE than in those with BM. Our findings suggest that MCP-1, sCD14, IL-6, IL-10, cortisol, and HBP are modulated by the source of sepsis and that elevated MCP-1 and cortisol plasma levels are associated with sepsis-induced organ dysfunction.

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Elevated plasma levels of heparin-binding protein in intensive care unit patients with severe sepsis and septic shock

Critical Care ◽

10.1186/cc11353 ◽

2012 ◽

Vol 16 (3) ◽

pp. R90 ◽

Cited By ~ 53

Author(s):

Adam Linder ◽

Per Åkesson ◽

Malin Inghammar ◽

Carl-Johan Treutiger ◽

Anna Linnér ◽

...

Keyword(s):

Intensive Care Unit ◽

Septic Shock ◽

Severe Sepsis ◽

Intensive Care ◽

Plasma Levels ◽

Binding Protein ◽

Heparin Binding ◽

Elevated Plasma ◽

Heparin Binding Protein ◽

Sepsis And Septic Shock

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Faculty Opinions recommendation of A longitudinal investigation of posttraumatic stress and depressive symptoms over the course of the year following medical-surgical intensive care unit admission.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717989043.793472793 ◽

2013 ◽

Author(s):

O Joseph Bienvenu

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Depressive Symptoms ◽

Intensive Care Unit Admission ◽

Posttraumatic Stress ◽

Surgical Intensive Care Unit ◽

Surgical Intensive Care ◽

Longitudinal Investigation

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Faculty Opinions recommendation of [Examination of maternal extended spectrum beta-lactamase bacterial colonization and follow-up of newborns requiring Neonatal Intensive Care Unit admission].

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727797260.793534178 ◽

2017 ◽

Author(s):

Jean-Ralph Zahar

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Intensive Care Unit Admission ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Bacterial Colonization ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum

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Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03564-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michinori Mayama ◽

Mamoru Morikawa ◽

Takashi Yamada ◽

Takeshi Umazume ◽

Kiwamu Noshiro ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Platelet Count ◽

Intensive Care Unit Admission ◽

Neonatal Intensive Care Unit ◽

Preterm Delivery ◽

Neonatal Intensive Care ◽

Organ Damage ◽

Severe Thrombocytopenia ◽

Relative Risks

Abstract Background Currently, there is a disagreement between guidelines regarding platelet count cut-off values as a sign of maternal organ damage in pre-eclampsia; the American College of Obstetricians and Gynecologists guidelines state a cut-off value of < 100 × 109/L; however, the International Society for the Study of Hypertension in Pregnancy guidelines specify a cut-off of < 150 × 109/L. We evaluated the effect of mild thrombocytopenia: platelet count < 150 × 109/L and ≥ 100 × 109/L on clinical features of pre-eclampsia to examine whether mild thrombocytopenia reflects maternal organ damage in pre-eclampsia. Methods A total of 264 women were enrolled in this study. Participants were divided into three groups based on platelet count levels at delivery: normal, ≥ 150 × 109/L; mild thrombocytopenia, < 150 × 109/L and ≥ 100 × 109/L; and severe thrombocytopenia, < 100 × 109/L. Risk of severe hypertension, utero-placental dysfunction, maternal organ damage, preterm delivery, and neonatal intensive care unit admission were analyzed based on platelet count levels. Estimated relative risk was calculated with a Poisson regression analysis with a robust error. Results Platelet counts indicated normal levels in 189 patients, mild thrombocytopenia in 51 patients, and severe thrombocytopenia in 24 patients. The estimated relative risks of severe thrombocytopenia were 4.46 [95 % confidence interval, 2.59–7.68] for maternal organ damage except for thrombocytopenia, 1.61 [1.06–2.45] for preterm delivery < 34 gestational weeks, and 1.35 [1.06–1.73] for neonatal intensive care unit admission. On the other hand, the estimated relative risks of mild thrombocytopenia were 0.97 [0.41–2.26] for maternal organ damage except for thrombocytopenia, 0.91 [0.62–1.35] for preterm delivery < 34 gestational weeks, and 0.97 [0.76–1.24] for neonatal intensive care unit admission. Conclusions Mild thrombocytopenia was not associated with severe features of pre-eclampsia and would not be suitable as a sign of maternal organ damage.

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