Adiponectin as a Predictor for the Severity of Sepsis in ICU Patients
American Journal of Internal Medicine
Volume 3, Issue 1, January 2015, Pages: 6-14
Received: Jan. 25, 2015; Accepted: Jan. 31, 2015; Published: Feb. 6, 2015
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Mohammed Amin Abd-Elghany, Intensive Care Medicine Department, Theodor Bilharz Research Institute, Cairo, Egypt
Nahed Salah Eldin, Anesthesia and Intensive Care Medicine Department, Ain Shams University, Cairo, Egypt
Sherif Wadie, Anesthesia and Intensive Care Medicine Department, Ain Shams University, Cairo, Egypt
Mervat Mohammed El Damarawy, Intensive Care Medicine Department, Theodor Bilharz Research Institute, Cairo, Egypt
Fady Adib Abd-El-malek, Anesthesia and Intensive Care Medicine Department, Ain Shams University, Cairo, Egypt
Ashraf Abd El-Khalik Barakat, Intensive Care Medicine Department, Theodor Bilharz Research Institute, Cairo, Egypt
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Sepsis is widely diagnosed In ICU patients. The sepsis markers are numerous with variable sensitivity and specificity. Adiponectin is a protein hormone that is secreted from adipose tissue into the bloodstream. It is a key substance in metabolic syndrome and has an anti-inflammatory property. The relationship between adiponectin and sepsis is unclear. In the current study, we aim to demonstrate that low plasma adiponectin level could be an early predictor for morbidity and mortality of sepsis by its comparison with c-reactive protein, serum lactate and procalcitonine. Thirty patients admitted to the intensive care unit with picture clinically suggesting sepsis were enrolled in the study. Predisposition, insult/infection, response, and organ dysfunction (PIRO) score was used to follow the course of the septic process. Plasma adiponectin level, serum lactate level, procalcitonin level(PCT), c-reactive protein(CRP) were checked on day1 then day 4 then day 7 and so on until ICU discharge or demise for a total of 28 days . PIRO score was able to expect sepsis prognosis with high statistical significance. Procalcitonin, serum lactate and adiponectin were valuable in follow up the sepsis prognosis with P value (0, 0.01 & 0 respectively) on the contrary CRP had poor prognostic value in sepsis follow up (P value 0.16).We conclude that PIRO score is an effective model for staging of sepsis and predict mortality. Measuring serial procalcitonin levels may be the most useful in order to understand the trend, identify the peak, and be able to identify resolution of sepsis. Early high lactate level is a predictor for poor prognosis of sepsis. Adiponectin is similar to procalcitinin in early detection of sepsis & can be used as a prognostic indicator with considering that adiponectin level could be affected by other metabolic disorders.
Sepsis, Sepsis Markers, PIRO Score, Adiponectin
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Mohammed Amin Abd-Elghany, Nahed Salah Eldin, Sherif Wadie, Mervat Mohammed El Damarawy, Fady Adib Abd-El-malek, Ashraf Abd El-Khalik Barakat, Adiponectin as a Predictor for the Severity of Sepsis in ICU Patients, American Journal of Internal Medicine. Vol. 3, No. 1, 2015, pp. 6-14. doi: 10.11648/j.ajim.20150301.12
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