scholarly journals Persistently higher serum sCD40L levels are associated with outcome in septic patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yingjian Liang ◽  
Chengrui Zhu ◽  
Yini Sun ◽  
Zhiliang Li ◽  
Liang Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Odds Ratio ◽  
Cd40 Ligand ◽  
Surgical Patients ◽  
Soluble Cd40 Ligand ◽  
Icu Admission ◽  
Time Changes ◽  
And Control ◽  
Type Of Surgery

Abstract Background Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and surgical sepsis patients (SS) during the first 3 days after intensive care unit (ICU) admission and to observe the association between sCD40L and mortality. Methods Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with those in 19 SWS patients. Serum sCD40L concentration was detected by ELISA. Survival at 28 days served as the endpoint. Results SS had significantly higher sCD40L levels than SWS and control patients. We observed an association between sCD40L levels ≥1028.75 pg/mL at day 2 and 28-day mortality (odds ratio = 7.888; 95% confidence interval = 1.758 to 35.395; P = 0.007). We could not discover any significant differences in sex, presence of septic shock, site of infection, length of stay in the ICU, PaO2/FiO2 ratio, incidence of AKI, ARDS, or type of surgery between nonsurvivors and survivors. Conclusions Septic patients show persistently higher circulating sCD40L levels in the first 3 days after ICU admission, and serum sCD40L levels are associated with the mortality of patients with sepsis. Thus, serum sCD40L may be used as a reliable biomarker and therapeutic target in sepsis.

scholarly journals Persistently higher serum sCD40L levels are associated with outcome in septic patients

2021 ◽  
Author(s):  
Yingjian Liang ◽  
Chengrui Zhu ◽  
Yini Sun ◽  
Zhiliang Li ◽  
Liang Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Odds Ratio ◽  
Cd40 Ligand ◽  
Surgical Patients ◽  
Soluble Cd40 Ligand ◽  
Icu Admission ◽  
Time Changes ◽  
And Control ◽  
Type Of Surgery

Abstract Background: Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and surgical sepsis patients (SS) during the first three days after intensive care unit (ICU) admission and to observe the association between sCD40L and mortality.Methods: Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with those in 19 SWS patients. Serum sCD40L concentration was detected by ELISA. Survival at 28 days served as the endpoint.Results: SS had significantly higher sCD40L levels than SWS and control patients. We observed an association between sCD40L levels ≥1028.75 pg/mL at day 2 and 28-day mortality (odds ratio=7.888; 95% confidence interval=1.758 to 35.395; P=0.007). We could not discover any significant differences in sex, presence of septic shock, site of infection, length of stay in the ICU, PaO2/FiO2 ratio, incidence of AKI, ARDS, or type of surgery between nonsurvivors and survivors.Conclusions: Septic patients show persistently higher circulating sCD40L levels in the first three days after ICU admission, and serum sCD40L levels are associated with the mortality of patients with sepsis. Thus, serum sCD40L may be used as a reliable biomarker and therapeutic target in sepsis.

scholarly journals Persistently higher serum sCD40L levels are associated with outcome in septic patients

2021 ◽  
Author(s):  
Yingjian Liang ◽  
Chengrui Zhu ◽  
Yini Sun ◽  
Zhiliang Li ◽  
Liang Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Odds Ratio ◽  
Cd40 Ligand ◽  
Surgical Patients ◽  
Soluble Cd40 Ligand ◽  
Icu Admission ◽  
Time Changes ◽  
And Control ◽  
Type Of Surgery

Abstract Background: Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and in surgical sepsis patients (SS) during the first three days at intensive care unit (ICU) admission and to observe the association between sCD40L and mortality.Methods: Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with 19 SWS patients. Serum sCD40L concentration was detected by ELISA. Survival at 28 days was used as the endpoint.Results: SS had significantly higher sCD40L levels than SWS and control patients. We observed an association between sCD40L levels ≥1028.75 pg/ml at day 2 and 28-day mortality (odds ratio = 7.888; 95% confidence interval = 1.758 to 35.395; P= 0.007). We could not discover any significant differences in gender, presence of septic shock, site of infection, length of stay in the ICU, PaO2/FiO2 ratio, incidence of AKI, ARDS, or type of surgery between nonsurvivors and survivors.Conclusions: Septic patients show persistently higher circulating sCD40L levels in the first three days at ICU admission, and the serum sCD40L levels are associated with the mortality of patients with sepsis; thus, serum sCD40L may be used as a reliable biomarker and therapeutic target in sepsis.

scholarly journals Persistently higher serum sCD40L levels are associated with outcome in septic patients

2020 ◽  
Author(s):  
Yingjian Liang ◽  
Chengrui Zhu ◽  
Yini Sun ◽  
Zhiliang Li ◽  
Liang Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Odds Ratio ◽  
Cd40 Ligand ◽  
Surgical Patients ◽  
Soluble Cd40 Ligand ◽  
Icu Admission ◽  
Time Changes ◽  
And Control ◽  
Type Of Surgery

Abstract Background: Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and in surgical sepsis patients (SS) during the first three days at intensive care unit(ICU) admission and to observe the association between sCD40L and mortality. Methods: Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with 19 SWS patients. Serum sCD40L concentration was detected by ELISA. Survival at 28 days was used as the endpoint. Results: SS had significantly higher sCD40L levels than SWS and control patients. We observed an association between sCD40L levels ≥1028.75 pg/ml at day 2 and 28-day mortality (odds ratio = 7.888; 95% confidence interval = 1.758 to 35.395; P= 0.007). We could not discover any significant differences in gender, presence of septic shock, site of infection, length of stay in the ICU, PaO2/FiO2 ratio, incidence of AKI, ARDS, or type of surgery between nonsurvivors and survivors. Conclusions: Septic patients show persistently higher circulating sCD40L levels in the first three days at ICU admission, and the serum sCD40L levels are associated with the mortality of patients with sepsis; thus, serum sCD40L could be usedas a reliable biomarker and therapeutic target in sepsis.

scholarly journals Persistently higher serum sCD40L levels are associated with outcome in septic patients

2020 ◽  
Author(s):  
Yingjian Liang ◽  
Chengrui Zhu ◽  
Yini Sun ◽  
Zhiliang Li ◽  
Liang Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Odds Ratio ◽  
Cd40 Ligand ◽  
Surgical Patients ◽  
Soluble Cd40 Ligand ◽  
Icu Admission ◽  
Time Changes ◽  
And Control ◽  
Type Of Surgery

Abstract Background: Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and in surgical sepsis patients (SS) during the first three days at intensive care unit (ICU) admission and to observe the association between sCD40L and mortality.Methods: Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with 19 SWS patients. Serum sCD40L concentration was detected by ELISA. Survival at 28 days was used as the endpoint.Results: SS had significantly higher sCD40L levels than SWS and control patients. We observed an association between sCD40L levels ≥1028.75 pg/ml at day 2 and 28-day mortality (odds ratio = 7.888; 95% confidence interval = 1.758 to 35.395; P= 0.007). We could not discover any significant differences in gender, presence of septic shock, site of infection, length of stay in the ICU, PaO2/FiO2 ratio, incidence of AKI, ARDS, or type of surgery between nonsurvivors and survivors.Conclusions: Septic patients show persistently higher circulating sCD40L levels in the first three days at ICU admission, and the serum sCD40L levels are associated with the mortality of patients with sepsis; thus, serum sCD40L may be used as a reliable biomarker and therapeutic target in sepsis.

scholarly journals Persistently higher serum sCD40L levels are associated with mortality in septic patients

2020 ◽  
Author(s):  
Yingjian Liang ◽  
Chengrui Zhu ◽  
Yini Sun ◽  
Zhiliang Li ◽  
Liang Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Cd40 Ligand ◽  
Surgical Patients ◽  
Soluble Cd40 Ligand ◽  
Icu Admission ◽  
Time Changes ◽  
And Control

Abstract Background Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and in surgical sepsis patients (SS) during the first three days at Intensive Care Unit (ICU) admission, and to observe the association between sCD40L and mortality. Methods Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with 19 SWS. Serum sCD40L concentration was detected by ELISA. Survival at 28-days was used as the endpoint. Results SS had significantly higher sCD40L levels than SWS and control patients. Advanced age (P = 0.023) was observed in the group of nonsurviving patients compared with surviving SS. We observed an association between sCD40L levels ≥ 1028.75 pg/ml at day 2 and 28-days mortality (odds ratio = 7.888; 95% confidence interval = 1.758 to 35.395; P = 0.007). Conclusions Septic patients show persistently higher circulating sCD40L levels in the first three days at ICU admission, and it is likely that sCD40L on the day 2 may have a predictive value; thus, serum sCD40L could be used as a reliable biomarker and therapeutic target in sepsis.

Predicting value of prehospital body temperature for ICU admission of septic shock patients

2019 ◽  
Vol 18 (1) ◽  
pp. 56-58
Author(s):  
Romain Jouffroy ◽  
◽  
Anastasia Saade ◽  
Stephane Durand ◽  
Pascal Philippe ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Body Temperature ◽  
Propensity Score Analysis ◽  
Call Centre ◽  
Icu Patients ◽  
Icu Admission ◽  
Score Analysis ◽  
The Mean ◽  
Proper Orientation

To specify whether an association exists between pre-hospital body temperature collected by the emergency medical services (EMS) call centre, and intensive care unit (ICU) admission of patients with septic shock. An observational study based on data collected by the EMS of Paris. All septic shocks were included. Among, the 140 calls concerning septic shock, 22 patients (16%) were admitted to ICU. The mean core temperature was 37.4±1.6°C for ICU and 38.6±1.1°C (p<4.10^-5) for non-ICU patients. Using propensity score analysis, the relative risk for ICU admission of patients with pre-hospital fever or hypothermia was 0.31 and 2 respectively. The study highlights the potential usefulness of early temperature measurement in septic shock patients to allow early proper orientation.

scholarly journals Oseltamivir Use Among Children and Adults Hospitalized With Community-Acquired Pneumonia

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Ikwo K. Oboho ◽  
Anna Bramley ◽  
Lyn Finelli ◽  
Alicia Fry ◽  
Krow Ampofo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Differential Diagnosis ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Influenza Season ◽  
Community Acquired Pneumonia ◽  
Severe Illness ◽  
Factors Associated ◽  
Icu Admission ◽  
Clinician Education

Abstract Background Data on oseltamivir treatment among hospitalized community-acquired pneumonia (CAP) patients are limited. Methods Patients hospitalized with CAP at 6 hospitals during the 2010−2012 influenza seasons were included. We assessed factors associated with oseltamivir treatment using logistic regression. Results Oseltamivir treatment was provided to 89 of 1627 (5%) children (&lt;18 years) and 143 of 1051 (14%) adults. Among those with positive clinician-ordered influenza tests, 39 of 61 (64%) children and 37 of 48 (77%) adults received oseltamivir. Among children, oseltamivir treatment was associated with hospital A (adjusted odds ratio [aOR], 2.76; 95% confidence interval [CI], 1.36−4.88), clinician-ordered testing performed (aOR, 2.44; 95% CI, 1.47−5.19), intensive care unit (ICU) admission (aOR, 2.09; 95% CI, 1.27−3.45), and age ≥2 years (aOR, 1.43; 95% CI, 1.16−1.76). Among adults, oseltamivir treatment was associated with clinician-ordered testing performed (aOR, 8.38; 95% CI, 4.64−15.12), hospitals D and E (aOR, 3.46−5.11; 95% CI, 1.75−11.01), Hispanic ethnicity (aOR, 2.06; 95% CI, 1.18−3.59), and ICU admission (aOR, 2.05; 95% CI, 1.34−3.13). Conclusions Among patients hospitalized with CAP during influenza season, oseltamivir treatment was moderate overall and associated with clinician-ordered testing, severe illness, and specific hospitals. Increased clinician education is needed to include influenza in the differential diagnosis for hospitalized CAP patients and to test and treat patients empirically if influenza is suspected.

scholarly journals Circulating Proenkephalin, Acute Kidney Injury, and Its Improvement in Patients with Severe Sepsis or Shock

2018 ◽  
Vol 64 (9) ◽  
pp. 1361-1369 ◽  
Author(s):  
Pietro Caironi ◽  
Roberto Latini ◽  
Joachim Struck ◽  
Oliver Hartmann ◽  
Andreas Bergmann ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Intensive Care ◽  
Serum Creatinine ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Kidney Injury ◽  
Baseline Serum

Abstract BACKGROUND Acute kidney injury (AKI) occurs in many critically ill patients and is associated with high mortality. We examined whether proenkephalin could predict incident AKI and its improvement in septic patients. METHODS Plasma proenkephalin A 119–159 (penKid) was assayed in 956 patients with sepsis or septic shock enrolled in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial to test its association with incident AKI, improvement of renal function, need for renal replacement therapy (RRT), and mortality. RESULTS Median [Q1–Q3] plasma penKid concentration on day 1 [84 (20–159) pmol/L[ was correlated with serum creatinine concentration (r = 0.74); it was higher in patients with chronic renal failure and rose progressively with the renal Sequential Organ Failure Assessment subscore. It predicted incident AKI within 48 h (adjusted odds ratio, 3.3; 95% CI, 2.1–5.1; P &lt; 0.0001) or 1 week [adjusted hazard ratio, 2.1 (1.7–2.8); P &lt; 0.0001] and future RRT during the intensive care unit stay [odds ratio, 4.0 (3.0–5.4)]. PenKid was also associated with improvements in renal function in patients with baseline serum creatinine &gt;2 mg/dL, both within the next 48 h [adjusted odds ratio, 0.31 (0.18–0.54), P &lt; 0.0001] and 1 week [0.23 (0.12–0.45)]. The time course of penKid concentrations predicted AKI and 90-day mortality. CONCLUSIONS Early measurement and the trajectory of penKid predict incident AKI, improvement of renal function, and the need for RRT in the acute phase after intensive care unit admission during sepsis or septic shock. PenKid measurement may be a valuable tool to test early therapies aimed at preventing the risk of AKI in sepsis.

Soluble CD40 ligand profiles in patients with septic shock

2017 ◽  
Vol 64 (4) ◽  
pp. 965-970 ◽  
Author(s):  
Patrícia Napoleão ◽  
Ekaterina Potapova ◽  
Sara Moleirinho ◽  
Carlota Saldanha ◽  
António Messias
Keyword(s):  
Septic Shock ◽  
Cd40 Ligand ◽  
Soluble Cd40 Ligand

Admission to the Regular Ward is Safe Following Uncomplicated Craniosynostosis Surgery: A Retrospective Study

FACE ◽  
2021 ◽  
pp. 273250162110279
Author(s):  
Deseray Sileo ◽  
Frank Walch ◽  
Brooke M. French ◽  
Krista Greenan ◽  
Sarah Graber ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Chart Review ◽  
Primary Outcome ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Icu Admission ◽  
Duration Of Hospitalization ◽  
Secondary Outcomes ◽  
Length Of Hospitalization ◽  
Type Of Surgery

Background: At our craniofacial center patients are routinely admitted to a regular ward, or floor, rather an intensive care unit (ICU) after uncomplicated craniosynostosis surgery. In this study, we review the safety of our postoperative placement policy, examining the rate of transfer from floor to ICU. Methods: The charts of patients who underwent craniosynostosis surgery from 2009 through 2017 at a single children’s hospital were reviewed. Postoperative hospital courses were characterized as preoperatively-planned ICU admission, perioperatively-planned ICU admission, or primary floor admission. The primary outcome was transfer from floor to ICU. Secondary outcomes included duration of hospitalization. Results: Chart review yielded 420 patients. Three hundred sixty-eight (88%) were admitted directly to the floor and 52 (12.0%) directly to an ICU. Of patients admitted to the floor, 2 (0.5%) were transferred to an ICU. Twenty-four patients with syndromic and 20 patients with multisutural craniosynostosis were admitted to the floor. Only 1 patient from each group (the same patient; 4.2% and 5.0%, respectively), was transferred to an ICU. Thirty-two ICU admissions were preoperatively planned and 20 were perioperatively planned. Reasons for preoperatively planned ICU admission included significant comorbidities and type of surgery. Reasons for perioperatively planned ICU admissions included significant intraoperative adverse events, excessive blood loss, and failure of clearance from the post-anesthesia care unit (PACU). Patients admitted to the ICU had a statistically significant longer mean length of hospitalization (4.8 days vs 2.7 days) than did patients admitted to the floor. Conclusions: Most postoperative craniosynostosis surgery patients—including patients with syndromic and/or multisutural synostosis—are managed safely on the floor at our center. Some patients still need postoperative ICU admission, but are easily identified preoperatively, intraoperatively, or in the PACU. Our findings should be applicable to other large craniofacial centers.

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