Diagnostic and Prognostic Value of Serum Calprotectin in Septic Shock Patients
Science Journal of Clinical Medicine
Volume 6, Issue 3, May 2017, Pages: 32-38
Received: May 27, 2017; Accepted: Jun. 5, 2017; Published: Jul. 10, 2017
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Authors
Mohamed Mostafa Megahed, Critical Care Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Sherif Abdel-Fattah, Critical Care Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Akram Refaie El-Sayed, Critical Care Medicine in Alexandria Main University Hospital, Alexandria University, Alexandria, Egypt
Islam El Sayed Ahmed, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
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Abstract
Calprotectin is a potent acute phase reactant with increases of more than 100 fold during inflamed conditions. We measured the diagnostic and prognostic value of serum calprotectin (SC) in septic shock. We enrolled 50 adult shocked patients admitted to intensive care unit. Then, classified into 2 groups; septic group (25) with well-defined septic shock with positive cultures. Non-septic group (25) with negative cultures or no source of sepsis. Blood samples for SC), C-reactive protein (CRP) and white blood cell count (WBCC) in the first 6 hours of ICU admission and re-obtained again on day 3. We observed the weaning of vasopressor and 7-days in ICU mortality. SC measured on day 1 was significantly higher in the septic group than the non-septic group (p<0.001). SC showed a good correlation with weaning of vasopressor (AUC was 0.764; p<0.028), while it showed relative correlation with 7-days in ICU mortality (AUC was 0.752; p<0.057) compared with other markers in the study. SC may aid in rapid identification of septic shock from non-septic shock at a cutoff of 2 µg/dl (sensitivity 92% and specificity 84%). Also the change in SC level may aid in prognostication of septic shock.
Keywords
Critical, Septic Shock, Vasopressor, Mortality, Calprotectin, CRP
To cite this article
Mohamed Mostafa Megahed, Sherif Abdel-Fattah, Akram Refaie El-Sayed, Islam El Sayed Ahmed, Diagnostic and Prognostic Value of Serum Calprotectin in Septic Shock Patients, Science Journal of Clinical Medicine. Vol. 6, No. 3, 2017, pp. 32-38. doi: 10.11648/j.sjcm.20170603.11
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Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Torio, C. M. and R. M. Andrews, National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011: Statistical Brief #160, in Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. 2006, Agency for Healthcare Research and Quality (US): Rockville (MD).
[2]
Martin, G. S., et al., The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med, 2003. 348(16): p. 1546-54.
[3]
Reinhart, K., et al., GEographic variations in use of recommended severe sepsis interventions observed in progress severe sepsis registry data. Chest, 2004. 126(4_MeetingAbstracts): p. 723S-b-724S.
[4]
Singer, M., et al., The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Jama, 2016. 315(8): p. 801-10.
[5]
Rivers, E., et al., Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med, 2001. 345(19): p. 1368-77.
[6]
Kumar, A., et al., The duration of hypotension before the initiation of antibiotic treatment is a critical determinant of survival in a murine model of Escherichia coli septic shock: association with serum lactate and inflammatory cytokine levels. J Infect Dis, 2006. 193(2): p. 251-8.
[7]
Puskarich, M. A., et al., Association between timing of antibiotic administration and mortality from septic shock in patients treated with a quantitative resuscitation protocol. Crit Care Med, 2011. 39(9): p. 2066-71.
[8]
Vincent, J. L., et al., Sepsis in European intensive care units: results of the SOAP study. Crit Care Med, 2006. 34(2): p. 344-53.
[9]
Blanco, J., et al., Incidence, organ dysfunction and mortality in severe sepsis: a Spanish multicentre study. Crit Care, 2008. 12(6): p. R158.
[10]
Vincent, J. L., et al., International study of the prevalence and outcomes of infection in intensive care units. Jama, 2009. 302(21): p. 2323-9.
[11]
Vincent, J. L. and M. Beumier, Diagnostic and prognostic markers in sepsis. Expert Rev Anti Infect Ther, 2013. 11(3): p. 265-75.
[12]
Pierrakos, C. and J. L. Vincent, Sepsis biomarkers: a review. Crit Care, 2010. 14(1): p. R15.
[13]
Yui, S., Y. Nakatani, and M. Mikami, Calprotectin (S100A8/S100A9), an inflammatory protein complex from neutrophils with a broad apoptosis-inducing activity. Biol Pharm Bull, 2003. 26(6): p. 753-60.
[14]
Berntzen, H. B. and M. K. Fagerhol, L1, a major granulocyte protein; isolation of high quantities of its subunits. Scand J Clin Lab Invest, 1990. 50(7): p. 769-74.
[15]
Nacken, W. and C. Kerkhoff, The hetero-oligomeric complex of the S100A8/S100A9 protein is extremely protease resistant. FEBS Lett, 2007. 581(26): p. 5127-30.
[16]
Kido, J., et al., Calprotectin release from human neutrophils is induced by Porphyromonas gingivalis lipopolysaccharide via the CD-14-Toll-like receptor-nuclear factor kappaB pathway. J Periodontal Res, 2003. 38(6): p. 557-63.
[17]
McCormick, M. M., et al., S100A8 and S100A9 in human arterial wall. Implications for atherogenesis. J Biol Chem, 2005. 280(50): p. 41521-9.
[18]
Vogl, T., et al., MRP8 and MRP14 control microtubule reorganization during transendothelial migration of phagocytes. Blood, 2004. 104(13): p. 4260-8.
[19]
Kerkhoff, C., M. Klempt, and C. Sorg, Novel insights into structure and function of MRP8 (S100A8) and MRP14 (S100A9). Biochim Biophys Acta, 1998. 1448(2): p. 200-11.
[20]
Johne, B., et al., Functional and clinical aspects of the myelomonocyte protein calprotectin. Mol Pathol, 1997. 50(3): p. 113-23.
[21]
Ehlermann, P., et al., Increased proinflammatory endothelial response to S100A8/A9 after preactivation through advanced glycation end products. Cardiovasc Diabetol, 2006. 5: p. 6.
[22]
Bealer, J. F. and M. Colgin, S100A8/A9: a potential new diagnostic aid for acute appendicitis. Acad Emerg Med, 2010. 17(3): p. 333-6.
[23]
Kharbanda, A. B., et al., Novel serum and urine markers for pediatric appendicitis. Acad Emerg Med, 2012. 19(1): p. 56-62.
[24]
Striz, I. and I. Trebichavsky, Calprotectin - a pleiotropic molecule in acute and chronic inflammation. Physiol Res, 2004. 53(3): p. 245-53.
[25]
Le Gall, J.-R., S. Lemeshow, and F. Saulnier, A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. Jama, 1993. 270(24): p. 2957-2963.
[26]
Knaus, W. A., et al., APACHE II: a severity of disease classification system. Critical care medicine, 1985. 13(10): p. 818-829.
[27]
Vincent, J. L., et al., The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med, 1996. 22(7): p. 707-10.
[28]
Decembrino, L., et al., Serum Calprotectin: A Potential Biomarker for Neonatal Sepsis. J Immunol Res, 2015. 2015: p. 147973.
[29]
Abdel-Maaboud, M., A.-A. M. El-Mazary, and A. M. Osman, Serum calprotectin as a diagnostic marker of late onset sepsis in full-term neonates. Egyptian Journal of Pediatric Allergy and Immunology (The), 2012. 10(1).
[30]
Terrin, G., et al., Serum calprotectin: an antimicrobial peptide as a new marker for the diagnosis of sepsis in very low birth weight newborns. Clinical and Developmental Immunology, 2011. 2011.
[31]
Huang, L., et al., Serum Calprotectin Expression as a Diagnostic Marker for Sepsis in Postoperative Intensive Care Unit Patients. J Interferon Cytokine Res, 2016. 36(10): p. 607-616.
[32]
Póvoa, P., et al., C-reactive protein as an indicator of sepsis. Intensive Care Medicine, 1998. 24(10): p. 1052-1056.
[33]
Povoa, P., et al., C-reactive protein as a marker of infection in critically ill patients. Clin Microbiol Infect, 2005. 11(2): p. 101-8.
[34]
Castelli, G. P., et al., Procalcitonin, C-reactive protein, white blood cells and SOFA score in ICU: diagnosis and monitoring of sepsis. Minerva Anestesiol, 2006. 72(1-2): p. 69-80.
[35]
Barati, M., et al., Comparison of WBC, ESR, CRP and PCT serum levels in septic and non-septic burn cases. Burns, 2008. 34(6): p. 770-774.
[36]
Clec’h, C., et al., Diagnostic and prognostic value of procalcitonin in patients with septic shock. Critical care medicine, 2004. 32(5): p. 1166-1169.
[37]
Bone, R. C., et al., Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest, 1992. 101(6): p. 1644-55.
[38]
Churpek, M. M., et al., Incidence and Prognostic Value of the Systemic Inflammatory Response Syndrome and Organ Dysfunctions in Ward Patients. Am J Respir Crit Care Med, 2015. 192(8): p. 958-64.
[39]
Kaukonen, K.-M., et al., Systemic inflammatory response syndrome criteria in defining severe sepsis. New England Journal of Medicine, 2015. 372(17): p. 1629-1638.
[40]
Levy, M. M., et al., 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med, 2003. 31(4): p. 1250-6.
[41]
Suberviola, B., et al., Prognostic value of procalcitonin, C-reactive protein and leukocytes in septic shock. Medicina Intensiva (English Edition), 2012. 36(3): p. 177-184.
[42]
Ferreira, F. L., et al., Serial evaluation of the SOFA score to predict outcome in critically ill patients. Jama, 2001. 286(14): p. 1754-1758.
[43]
JONES, A. E., S. TRZECIAK, and J. A. KLINE, The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Critical care medicine, 2009. 37(5): p. 1649-1654.
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