scholarly journals Correlation of Redox Status with Procalcitonin and C-reactive Protein in Septic Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jasna Petrovic ◽  
Tamara Nikolic Turnic ◽  
Vladimir Zivkovic ◽  
Marijana Andjic ◽  
Nevena Draginic ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Septic Shock ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Case Series ◽  
Redox Status ◽  
Prospective Clinical Study ◽  
C Reactive Protein ◽  
Reactive Protein

Based on the role of oxidative stress in the pathophysiological mechanisms of sepsis and the importance of PCT as a clinically applicable biomarker for early detection of inflammatory response initiation, we aimed this study at examining the correlation between PCT levels and oxidative stress parameters (prooxidants and antioxidants) in patients with sepsis. This study was designed as a case-series prospective clinical study which involved 103 critically ill patients and 17 healthy participants with diagnosis of sepsis/septic shock (over 18 years of age, both gender) admitted to the Intensive Care Unit (ICU) of Valjevo General Hospital in Serbia. All subjects were divided into patients who were operated on/underwent surgery before sampling and have sepsis (n=24), patients who were operated on/underwent surgery before sampling and have septic shock (n=25), patients who were not operated on/did not undergo surgery before sampling and have sepsis (n=26), patients who were not operated on/did not undergo surgery before sampling and have septic shock (n=28), and participants who are healthy (n=17). PCT has confirmed a positive correlation with prooxidants and type of critical illness, and performing surgical intervention diminished oxidative stress in patients with septic shock. Prognosis in critically ill patients was strongly associated with PCT levels but not with nonspecifically C-reactive protein.

scholarly journals Interpretation of C-Reactive Protein Concentrations in Critically Ill Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Christophe Lelubre ◽  
Sophie Anselin ◽  
Karim Zouaoui Boudjeltia ◽  
Patrick Biston ◽  
Michaël Piagnerelli
Keyword(s):  
Clinical Practice ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Inflammatory Process ◽  
Early Recognition ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Pathophysiological Role ◽  
Inflammatory Processes

Infection is often difficult to recognize in critically ill patients because of the marked coexisting inflammatory process. Lack of early recognition prevents timely resuscitation and effective antimicrobial therapy, resulting in increased morbidity and mortality. Measurement of a biomarker, such as C-reactive protein (CRP) concentration, in addition to history and physical signs, could facilitate diagnosis. Although frequently measured in clinical practice, few studies have reported on the pathophysiological role of this biomarker and its predictive value in critically ill patients. In this review, we discuss the pathophysiological role of CRP and its potential interpretation in the inflammatory processes observed in critically ill patients.

scholarly journals Arterial Carboxyhemoglobin Levels In Covid-19 Critically Ill Patients

2020 ◽  
Author(s):  
Paul Paccaud ◽  
Diego Castanares-Zapatero ◽  
Ludovic Gerard ◽  
Virginie Montiel ◽  
Xavier Wittebole ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Carbon Monoxide ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Retrospective Cohort ◽  
C Reactive Protein ◽  
Icu Mortality ◽  
Icu Patients ◽  
Reactive Protein ◽  
Over Time

Abstract Background : Oxidative stress conditions may be responsible for an up-regulation of the expression of heme oxygenase, the enzyme synthesizing carbon monoxide (CO) in cells. Elevated levels of arterial carboxyhemoglogin (CO-Hb) have been found in critically ill patients, including those suffering from acute lung injury. We aimed to investigate the changes of arterial CO-Hb levels in COVID-19 critically ill patients.Methods : A retrospective cohort study was conducted on the medical charts of 63 patients admitted in the ICU for severe COVID-19 infection over the period March 1 – May 31, 2020.Results : The overall ICU mortality rate was 39%. Non-survivors had a significantly higher profile of arterial CO-Hb levels than survivors (p<0.001), but arterial CO-Hb increased significantly from admission to day 30 in both groups (p<0.001). Mortality could not be predicted by the changes in arterial CO-Hb, but there was a correlation between the maximal arterial CO-Hb value and SOFA score on admission. No correlation could be demonstrated between arterial CO-Hb and serum C-reactive protein (CRP) as a marker of the inflammatory response.Conclusions : A greater increase of arterial CO-Hb levels over time may represent another marker of severity of COVID-19 infection in ICU patients.

scholarly journals Role of AScorbic acid Infusion in critically ill patients with Transfusion Related Acute Lung Injury (ASTRALI)

2021 ◽  
Author(s):  
Amira kassem ◽  
Islam Ahmed ◽  
Gamal Omran ◽  
Mohamed Megahed ◽  
Tamer Habib
Keyword(s):  
Oxidative Stress ◽  
Ascorbic Acid ◽  
Superoxide Dismutase ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Interleukin 10 ◽  
High Dose ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Intravenous Ascorbic Acid

Introduction: In critically ill patients, Transfusion Related Acute Lung Injury (TRALI) remains the leading cause of transfusion-related fatalities in critical care setting and associated with inflammation and oxidative stress state. Recent research raised the potential efficacy of high dose intravenous ascorbic acid in critically ill patients. Objective: The aim of this trial was to investigate the effect of high dose intravenous ascorbic acid (VC) as a targeted therapy for TRALI in terms of serum proinflammatory (interleukin-8, interleukin-1β, C-reactive protein), anti-inflammatory (interleukin-10), oxidative stress (superoxide dismutase, malondialdehyde) markers, and plasma VC levels. Secondary outcomes were oxygenation (PaO2/FiO2 ratio), vasopressor use, duration of mechanical ventilation, ICU length of stay, 7-days mortality and 28-days mortality. Methods: Eighty critically ill patients with TRALI (n=80) were randomized to receive 2.5gm/6hr intravenous vitamin C for 96 hours (ASTRALI group) or placebo. Patients were followed-up to measure the outcomes initially (T0) and at the end of treatment (T96). Results: When compared to control group, ASTRALI group at T96, showed significantly higher median of interleukin-10 (31.6 ± 25.8 Vs. 17.7 ± 12.0 pg/mL, p<0.0001) levels and superoxide dismutase (12876 ± 4627 U/L Vs. 5895 ± 6632 U/L, p<0.0001) activities, lower median C-reactive protein (76 ± 50 Vs. 89 ± 56 mg/L, p=0.033), interleukin-8 (11.8 ± 7.3, 35.5 ± 19.8 pg/mL, p<0.0001), and malondialdehyde (0.197 ± 0.034 Vs. 0.234 ± 0.074 µM/L, p=0.002) levels. Conclusion: High dose ascorbic acid was associated with significantly reduced oxidative stress, reduced pro-inflammatory markers except IL-1β, elevated anti-inflammatory marker, and elevated plasma VC levels

scholarly journals A novel procalcitonin-based score for detecting sepsis among critically ill patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245748
Author(s):  
Tung-Lin Tsui ◽  
Ya-Ting Huang ◽  
Wei-Chih Kan ◽  
Mao-Sheng Huang ◽  
Min-Yu Lai ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Validation Cohort ◽  
Multivariate Logistic Regression Analysis ◽  
Sepsis Group ◽  
C Reactive Protein ◽  
Multivariate Logistic Regression ◽  
Reactive Protein

Background Procalcitonin (PCT) has been widely investigated as an infection biomarker. The study aimed to prove that serum PCT, combining with other relevant variables, has an even better sepsis-detecting ability in critically ill patients. Methods We conducted a retrospective cohort study in a regional teaching hospital enrolling eligible patients admitted to intensive care units (ICU) between July 1, 2016, and December 31, 2016, and followed them until March 31, 2017. The primary outcome measurement was the occurrence of sepsis. We used multivariate logistic regression analysis to determine the independent factors for sepsis and constructed a novel PCT-based score containing these factors. The area under the receiver operating characteristics curve (AUROC) was applied to evaluate sepsis-detecting abilities. Finally, we validated the score using a validation cohort. Results A total of 258 critically ill patients (70.9±16.3 years; 55.4% man) were enrolled in the derivation cohort and further subgrouped into the sepsis group (n = 115) and the non-sepsis group (n = 143). By using the multivariate logistic regression analysis, we disclosed five independent factors for detecting sepsis, namely, “serum PCT level,” “albumin level” and “neutrophil-lymphocyte ratio” at ICU admission, along with “diabetes mellitus,” and “with vasopressor.” We subsequently constructed a PCT-based score containing the five weighted factors. The PCT-based score performed well in detecting sepsis with the cut-points of 8 points (AUROC 0.80; 95% confidence interval (CI) 0.74–0.85; sensitivity 0.70; specificity 0.76), which was better than PCT alone, C-reactive protein and infection probability score. The findings were confirmed using an independent validation cohort (n = 72, 69.2±16.7 years, 62.5% men) (cut-point: 8 points; AUROC, 0.79; 95% CI 0.69–0.90; sensitivity 0.64; specificity 0.87). Conclusions We proposed a novel PCT-based score that performs better in detecting sepsis than serum PCT levels alone, C-reactive protein, and infection probability score.

scholarly journals Duration of antibiotic therapy in critically ill patients: a randomized controlled trial of a C-reactive protein-based protocol versus an evidence-based best practice strategy without biomarkers

2020 ◽  
Author(s):  
Isabela Nascimento Borges ◽  
Rafael Carneiro ◽  
Rafael Bergo ◽  
Larissa Martins ◽  
Enrico Colosimo ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Critically Ill ◽  
Antibiotic Treatment ◽  
Median Duration ◽  
Critically Ill Patients ◽  
Treatment Time ◽  
C Reactive Protein ◽  
Daily Monitoring ◽  
Reactive Protein ◽  
To Receive

Abstract Background: The rational use of antibiotics is one of the main strategies to limit the development of bacterial resistance . We therefore sought to evaluate the effectiveness of a C reactive protein-based protocol in reducing antibiotic treatment time in critically ill patients.Methods: A randomized, open-label, controlled clinical trial conducted in two intensive care units of a university hospital in Brazil. Critically ill infected adult patients were randomly allocated to: i) intervention to receive antibiotics guided by daily monitoring of CRP levels, and ii) control to receive antibiotics according to the best practices for rational use of antibiotics.Results : 130 patients were included in the CRP (n=64) and control (n=66) groups. In the intention to treat analysis, the median duration of antibiotic therapy for the index infectious episode was 7.0 (5.0-8.8) days in the CRP and 7.0 (7.0-11.3) days in the control (p = 0.011) groups. A significant difference in the treatment time between the two groups was identified in the curve of cumulative suspension of antibiotics, with less exposure in the CRP group (p = 0.007). In the per protocol analysis, involving 59 patients in each group, the median duration of antibiotic treatment was 6.0 (5.0-8.0) days for the CRP and 7.0 (7.0- 10.0) days for the control (p = 0.011) groups. Conclusions: Daily monitoring of CRP levels may aid in the reduction of antibiotic treatment time of critically ill patients, even in a scenario of judicious use of antimicrobials. Trial Registry : ClinicalTrials.gov Identifier: NCT02987790. Registered 09 December 2016, https://clinicaltrials.gov/ct2/show/NCT02987790 .

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