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.

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.

Māori health outcomes in an intensive care unit in Aotearoa New Zealand

2021 ◽  
pp. 0310057X2198971
Author(s):  
M Atif Mohd Slim ◽  
Hamish M Lala ◽  
Nicholas Barnes ◽  
Robert A Martynoga
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
New Zealand ◽  
Renal Replacement Therapy ◽  
Confidence Interval ◽  
Health Outcomes ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
One Year ◽  
Maori Health

Māori are the indigenous people of New Zealand, and suffer disparate health outcomes compared to non-Māori. Waikato District Health Board provides level III intensive care unit services to New Zealand’s Midland region. In 2016, our institution formalised a corporate strategy to eliminate health inequities for Māori. Our study aimed to describe Māori health outcomes in our intensive care unit and identify inequities. We performed a retrospective audit of prospectively entered data in the Australian and New Zealand Intensive Care Society database for all general intensive care unit admissions over 15 years of age to Waikato Hospital from 2014 to 2018 ( n = 3009). Primary outcomes were in–intensive care unit and in-hospital mortality. The secondary outcome was one-year mortality. In our study, Māori were over-represented relative to the general population. Compared to non-Māori, Māori patients were younger (51 versus 61 years, P < 0.001), and were more likely to reside outside of the Waikato region (37.2% versus 28.0%, P < 0.001) and in areas of higher deprivation ( P < 0.001). Māori had higher admission rates for trauma and sepsis ( P < 0.001 overall) and required more renal replacement therapy ( P < 0.001). There was no difference in crude and adjusted mortality in–intensive care unit (16.8% versus 16.5%, P = 0.853; adjusted odds ratio 0.98 (95% confidence interval 0.68 to 1.40)) or in-hospital (23.7% versus 25.7%, P = 0.269; adjusted odds ratio 0.84 (95% confidence interval 0.60 to 1.18)). One-year mortality was similar (26.1% versus 27.1%, P=0.6823). Our study found significant ethnic inequity in the intensive care unit for Māori, who require more renal replacement therapy and are over-represented in admissions, especially for trauma and sepsis. These findings suggest upstream factors increasing Māori risk for critical illness. There was no difference in mortality outcomes.

scholarly journals Staphylococcus aureusNasal Colonization and Subsequent Infection in Intensive Care Unit Patients: Does Methicillin Resistance Matter?

2010 ◽  
Vol 31 (6) ◽  
pp. 584-591 ◽  
Author(s):  
Hitoshi Honda ◽  
Melissa J. Krauss ◽  
Craig M. Coopersmith ◽  
Marin H. Kollef ◽  
Amy M. Richmond ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Confidence Interval ◽  
Methicillin Resistance ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Patient Specific ◽  
Icu Patients ◽  
Icu Admission

Background.Staphylococcus aureusis an important cause of infection in intensive care unit (ICU) patients. Colonization with methicillin-resistantS. aureus(MRSA) is a risk factor for subsequentS. aureusinfection. However, MRSA-colonized patients may have more comorbidities than methicillin-susceptibleS. aureus(MSSA)-colonized or noncolonized patients and therefore may be more susceptible to infection on that basis.Objective.To determine whether MRSA-colonized patients who are admitted to medical and surgical ICUs are more likely to develop anyS. aureusinfection in the ICU, compared with patients colonized with MSSA or not colonized withS. aureus,independent of predisposing patient risk factors.Design.Prospective cohort study.Setting.A 24-bed surgical ICU and a 19-bed medical ICU of a 1,252-bed, academic hospital.Patients.A total of 9,523 patients for whom nasal swab samples were cultured forS. aureusat ICU admission during the period from December 2002 through August 2007.Methods.Patients in the ICU for more than 48 hours were examined for an ICU-acquired S.aureusinfection, defined as development ofS. aureusinfection more than 48 hours after ICU admission.Results.S. aureuscolonization was present at admission for 1,433 (27.8%) of 5,161 patients (674 [47.0%] with MRSA and 759 [53.0%] with MSSA). An ICU-acquiredS. aureusinfection developed in 113 (2.19%) patients, of whom 75 (66.4%) had an infection due to MRSA. Risk factors associated with an ICU-acquiredS. aureusinfection included MRSA colonization at admission (adjusted hazard ratio, 4.70 [95% confidence interval, 3.07-7.21]) and MSSA colonization at admission (adjusted hazard ratio, 2.47 [95% confidence interval, 1.52-4.01]).Conclusion.ICU patients colonized with S.aureuswere at greater risk of developing aS. aureusinfection in the ICU. Even after adjusting for patient-specific risk factors, MRSA-colonized patients were more likely to developS. aureusinfection, compared with MSSA-colonized or noncolonized patients.

scholarly journals The clinical implications of sinus tachycardia in mild COVID-19 infection: A retrospective cohort study

2021 ◽  
Vol 9 ◽  
pp. 205031212110549
Author(s):  
Jenny Yi Chen Hsieh ◽  
Juliana Yin Li Kan ◽  
Shaikh Abdul Matin Mattar ◽  
Yan Qin
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Sinus Tachycardia ◽  
High Dependency ◽  
General Wards

Objectives: This study aims to estimate the prevalence of sinus tachycardia in hospitalized patients with mild COVID-19 infection and to identify the clinical, radiological, and biological characteristics associated with sinus tachycardia. Methods: A retrospective cohort study was conducted on patients with mild COVID-19 infection and sinus tachycardia during hospitalization. Outcomes measured included incidences of venous thromboembolism, high-dependency/intensive care unit admission, laboratory parameters, and radiological findings. Results: A total of 236 COVID-19 positive patients admitted to Singapore General Hospital isolation general wards from 1 June 2020 to 30 June 2020 were included in this study. Ninety-seven (41.1%) patients had sinus tachycardia on or during their admission. All patients were monitored in general wards and discharged to community quarantine facilities. None required oxygen support or high-dependency/intensive care unit admission. Sinus tachycardia was associated with increased C-reactive protein level (odds ratio = 1.033, 95% confidence interval = 1.002–1.066), abnormal chest X-ray findings (odds ratio = 3.142, 95% confidence interval = 1.390–7.104), and longer hospitalization (odds ratio = 1.117, 95% confidence interval = 1.010–1.236). There was no significant statistical association between sinus tachycardia and incidences of venous thromboembolism. Conclusion: This study suggests that patients with mild COVID-19 infection and concurrent sinus tachycardia are more likely to have higher inflammatory marker levels, abnormal imaging, and prolonged hospitalization. However, no significant association between sinus tachycardia and thromboembolism is identified in mild COVID-19 infection.

scholarly journals Factors associated with cerebral edema in children under 5 years of age admitted in an intensive care unit and their outcome

2019 ◽  
Vol 7 ◽  
pp. 205031211987462
Author(s):  
Shamin Islam ◽  
Monira Sarmin ◽  
Tahmeed Ahmed ◽  
Farzana Afroze ◽  
Mohammod Jobayer Chisti
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Confidence Interval ◽  
Cerebral Edema ◽  
Odds Ratio ◽  
Fatal Outcome ◽  
Severe Malnutrition ◽  
Clinical Predictors ◽  
Record System ◽  
Children Under 5

Objective: We aimed to evaluate risk factors and outcome of cerebral edema in children with diarrhea. Methods: In this retrospective chart analysis, data of all diarrheal children under 5 years of age having convulsion and admitted in intensive care unit were retrieved from an electronic medical record system of Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh, from 1st January 2011 to 31st December 2016. Comparison of clinical and laboratory characteristics was made between children with (cases = 22) and without cerebral edema (controls = 66). Results: Cases more often had a fatal outcome than controls (36% vs 8%, p = 0.003). In logistic regression analysis, after adjusting for potential confounders, the cases were independently associated with respiratory distress (odds ratio = 5.5, confidence interval = 1.55–19.62, p = 0.008), severe sepsis (odds ratio = 4.6, confidence interval = 1.24–16.77, p = 0.022), and severe malnutrition (odds ratio = 0.16, confidence interval = 0.04–0.74, p = 0.019). A rapid drop (>0.5 mmol/L per hour) in serum sodium did not have any impact on developing cerebral edema (p = 0.090). Conclusion: Identification of simple clinical predictors may help in the early treatment of cerebral edema that may further help in reducing deaths in such children especially in resource-poor settings. However, further research with prospective design is needed to consolidate our observation.

Arrhythmias in the paediatric intensive care unit: a prospective study of the rates and predictors of arrhythmias in children without underlying cardiac disease

2014 ◽  
Vol 25 (7) ◽  
pp. 1281-1289 ◽  
Author(s):  
Gina N. Cassel-Choudhury ◽  
Scott I. Aydin ◽  
Iris Toedt-Pingel ◽  
H. Michael Ushay ◽  
James S. Killinger ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Ventricular Tachycardia ◽  
Confidence Interval ◽  
Supraventricular Tachycardia ◽  
Cardiac Disease ◽  
Odds Ratio ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Central Venous

AbstractObjectiveArrhythmias are common in patients admitted to the paediatric intensive care unit. We sought to identify the rates of occurrence and types of arrhythmias, and determine whether an arrhythmia was associated with illness severity and paediatric intensive care unit length of stay.DesignThis is a prospective, observational study of all patients admitted to the paediatric intensive care unit at the Children’s Hospital at Montefiore from March to June 2012. Patients with cardiac disease or admitted for the treatment of primary arrhythmias were excluded. Clinical and laboratory data were collected and telemetry was reviewed daily. Tachyarrhythmias were identified as supraventricular tachycardia, ventricular tachycardia, and arrhythmias causing haemodynamic compromise or for which an intervention was performed.ResultsA total of 278 patients met the inclusion criteria and were analysed. There were 97 incidences of arrhythmia in 53 patients (19%) and six tachyarrhythmias (2%). The most common types of arrhythmias were junctional rhythm (38%), premature atrial contractions (24%), and premature ventricular contractions (22%). Tachyarrhythmias included three supraventricular tachycardia (50%) and three ventricular tachycardia (50%). Of the six tachyarrhythmias, four were related to placement or migration of central venous lines and two occurred during aminophylline infusion. Patients with an arrhythmia had longer duration of mechanical ventilation and paediatric intensive care unit stay (p<0.001). In multivariate analysis, central venous lines (odds ratio 3.1; 95% confidence interval 1.3–7.2, p=0.009) and aminophylline use (odds ratio 5.1; 95% confidence interval 1.7–14.9, p=0.003) were independent predictors for arrhythmias.ConclusionsArrhythmias were common in paediatric intensive care unit patients (19%), although tachyarrhythmias occurred rarely (2%). Central venous lines and use of aminophylline were identified as two clinical factors that may be associated with development of an arrhythmia.

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