tailieunhanh - Báo cáo y học: " Prognostic value of circulating amino-terminal pro-C-type natriuretic peptide in critically ill patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Prognostic value of circulating amino-terminal pro-C-type natriuretic peptide in critically ill patients. | Koch et al. Critical Care 2011 15 R45 http content 15 1 R45 KS CRITICAL CARE RESEARCH Open Access Prognostic value of circulating amino-terminal pro-C-type natriuretic peptide in critically ill patients Alexander Koch Sebastian Voigt Edouard Sanson Hanna Duckers Andreas Horn Henning W Zimmermann Christian Trautwein Frank Tacke Abstract Introduction C-type natriuretic peptide CNP is a paracrine molecule which is mainly synthesized in the vasculature. High levels have been reported in sepsis and CNP has been proposed as a biomarker predicting sepsis in traumatized patients. We aimed at evaluating the diagnostic and prognostic value of N-terminal pro-CNP NT-proCNP for predicting sepsis disease severity and mortality in critically ill medical patients. Methods 273 critically ill patients 197 patients with sepsis or septic shock 76 without evidence of sepsis and 43 healthy controls were consecutively included in a prospective clinical single-center non-interventional study at the Medical Intensive Care Unit RWTH-University Aachen Germany. Patients outcome was followed for about 1 year. NT-proCNP serum concentrations were determined upon ICU admission as well as in the mornings of day 3 and day 7 after admission. Intensive care treatment measures as well as routine and experimental laboratory parameters were recorded and analyzed. Results NT-proCNP serum concentrations upon admission to the ICU were elevated in critically ill patients as compared with healthy controls. Patients with sepsis had significantly higher NT-proCNP levels than non-sepsis patients. NT-proCNP was strongly associated with inflammatory parameters . C-reactive protein procalcitonin and TNF-a biomarkers of organ dysfunction and clinical composite scores APACHE-II SOFA SAPS2 . NT-proCNP levels at admission and day 3 were found to be a strong predictive marker for ICU- and overall survival. Moreover a decline of serum NT-proCNP after admission to the ICU was associated with reduced .