Intestinal fatty acid-binding protein level as a predictor of 28-day mortality and bowel ischemia in patients with septic shock: A preliminary study

Sekino, Motohiro; Funaoka, Hiroyuki; Sato, Shuntaro; Okada, Kyoko; Inoue, Hakuai; Yano, Rintaro; Matsumoto, Shoichi; Ichinomiya, Taiga; Higashijima, Ushio; Matsumoto, Shuhei; Hara, Tetsuya

doi:10.1016/j.jcrc.2017.07.012

Cited by 43 publications

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References 45 publications

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“…Of the 46 studies included in this review, 35 examined the association of brain natriuretic peptides (BNP, NT‐proBNP) with survival in patients with septic shock, presented in Table . The vast majority were prospective cohort studies.…”

Section: Resultsmentioning

confidence: 99%

“…This association was also evaluated by two studies in the setting of an RCT evaluating the use of 20% human albumin plus crystalloids or crystalloids alone in patients with severe sepsis or septic shock . In total, 30 studies, including the two conducted in the setting of the RCT, have found a significant association between elevated levels of brain natriuretic peptides and increased mortality …”

Section: Resultsmentioning

confidence: 99%

“…The primary outcome of this systematic review was to assess the utility of BNP and NT‐proBNP as prognostic markers in septic shock. Brain natriuretic peptides have been shown to be adequate predictors of mortality in septic shock by numerous studies . However, there are significant differences in the reported limits for an optimal cut‐off value, ranging from 210 to 800 ng/L for BNP, with suboptimal sensitivity and specificity .…”

Section: Discussionmentioning

confidence: 99%

“…Brain natriuretic peptides have been shown to be adequate predictors of mortality in septic shock by numerous studies. [14][15][16][17][18]20,21,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]39,41,42,[45][46][47] However, there are significant differences in the reported limits for an optimal cut-off value, ranging from 210 to 800 ng/L for BNP, 18,25 with suboptimal sensitivity and specificity. 25 The best reported values for sensitivity and specificity The Newcastle-Ottawa scale 12 is used to evaluate non-randomised studies.…”

Section: Discussionmentioning

confidence: 99%

“…24,27 In total, 30 studies, including the two conducted in the setting of the RCT, have found a significant association between elevated levels of brain natriuretic peptides and increased mortality. [14][15][16][17][18]20,21,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]39,41,42,[45][46][47] Various studies reported the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) of BNP and NT-proBNP in predicting mortality in septic shock. Several cut-off values have been proposed for both markers, 18,25,37,39,41,46,47 with some reporting that low BNP cut-off values (190 ng/L) were associated with a 5.7-fold increased risk of death (95% confidence interval [CI], 1.78-27.48; P < 0.014), 41 whereas others using higher cut-off values (800 ng/L) considered BNP a poor predictor of outcome.…”

Section: Association Of Brain Natriuretic Peptides With Survival Inmentioning

confidence: 99%

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The utility of brain natriuretic peptides in septic shock as markers for mortality and cardiac dysfunction: A systematic review

et al. 2019

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Objective To conduct a systematic review evaluating the utility of brain natriuretic peptide (BNP) and N‐terminal proBNP (NT‐proBNP) as biomarkers in adult patients with septic shock. Materials and Methods Pubmed/Medline databases were searched from inception to November 2018 using the search terms: (septic[Title/Abstract] AND shock[Title/Abstract]) AND bnp[Title/Abstract]) and (septic[Title/Abstract]) AND shock[Title/Abstract]) AND natriuretic[Title/Abstract]). No restriction was applied regarding date of publication. Comparative observational studies evaluating BNP and NT‐proBNP in patients with septic shock aged ≥18 years were eligible for inclusion. Bibliographies from the extracted articles were also reviewed to identify additional relevant publications. Results In total, 46 studies met all eligibility criteria and were included. A strong body of literature has demonstrated that in patients with septic shock, increased values of BNP and NT‐proBNP are associated with increased mortality. An increase from baseline BNP values has also been associated with increased mortality, whereas decreases from baseline values are not related to worse outcome. Brain natriuretic peptides have also been associated with cardiac dysfunction in patients with sepsis. Moreover, BNP values have been found to be significantly elevated in septic shock, regardless of cardiac dysfunction, and have been used to distinguish between septic and cardiogenic shock. Furthermore, BNP and NT‐proBNP are significantly increased in patients with septic shock, compared to patients with sepsis and severe sepsis. Conclusions BNP and NT‐proBNP appear to be reliable predictors of outcome in septic shock.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Association Of Brain Natriuretic Peptides With Survival Inmentioning

confidence: 99%

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The utility of brain natriuretic peptides in septic shock as markers for mortality and cardiac dysfunction: A systematic review

et al. 2019

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Diagnostik der akuten Organischämie

Szasz

Noitz

Dünser

2020

Med Klin Intensivmed Notfmed

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ZusammenfassungDer Begriff Ischämie beschreibt die Minderdurchblutung oder den kompletten Durchblutungsausfall eines oder mehrerer Organe. Der Früherkennung eines Schocks, der globalen Ischämie des Körpers, kommt eine essenzielle Bedeutung in der Notfall- und Intensivmedizin zu. Die klinische Untersuchung und Point-of-care-Labordiagnostik (z. B. Laktat, Basendefizit, zentral-/gemischtvenöse Sauerstoffsättigung, venös-arterieller Kohlendioxidpartialdruckgradient) stellen die wichtigsten Methoden zur Diagnose eines Schockzustands dar. Ein Schockzustand kann auch bei Patienten mit normo- oder hypertensiven Blutdruckwerten vorhanden sein. Im Rahmen eines Schockgeschehens kommt es zur Minderdurchblutung der Vital- und Viszeralorgane. Im 2. Teil dieses Manuskripts werden klinische, laborchemische und apparative Methoden zur Diagnose der schockassoziierten Minderdurchblutung von Gehirn, Herz, Niere und Darm zusammengefasst.

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Acute alcohol consumption increases systemic endotoxin bioactivity for days in healthy volunteers—with reduced intestinal barrier loss in female

Sturm

Haag

Janicova

et al. 2021

Eur J Trauma Emerg Surg

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Objective Trauma is the most common cause of death among young adults. Alcohol intoxication plays a significant role as a cause of accidents and as a potent immunomodulator of the post-traumatic response to tissue injury. Polytraumatized patients are frequently at risk to developing infectious complications, which may be aggravated by alcohol-induced immunosuppression. Systemic levels of integral proteins of the gastrointestinal tract such as syndecan-1 or intestinal fatty acid binding proteins (FABP-I) reflect the intestinal barrier function. The exact impact of acute alcohol intoxication on the barrier function and endotoxin bioactivity have not been clarified yet. Methods 22 healthy volunteers received a precisely defined amount of alcohol (whiskey–cola) every 20 min over a period of 4 h to reach the calculated blood alcohol concentration (BAC) of 1‰. Blood samples were taken before alcohol drinking as a control, and after 2, 4, 6, 24 and 48 h after beginning with alcohol consumption. In addition, urine samples were collected. Intestinal permeability was determined by serum and urine values of FABP-I, syndecan-1, and soluble (s)CD14 as a marker for the endotoxin translocation via the intestinal barrier by ELISA. BAC was determined. Results Systemic FABP-I was significantly reduced 2 h after the onset of alcohol drinking, and remained decreased after 4 h. However, at 6 h, FABP-I significantly elevated compared to previous measurements as well as to controls (p < 0.05). Systemic sCD14 was significantly elevated after 6, 24 and 48 h after the onset of alcohol consumption (p < 0.05). Systemic FABP-I at 2 h after drinking significantly correlated with the sCD14 concentration after 24 h indicating an enhanced systemic LPS bioactivity. Women showed significantly lower levels of syndecan-1 in serum and urine and urine for all time points until 6 h and lower FABP-I in the serum after 2 h. Conclusions Even relative low amounts of alcohol affect the immune system of healthy volunteers, although these changes appear minor in women. A potential damage to the intestinal barrier and presumed enhanced systemic endotoxin bioactivity after acute alcohol consumption is proposed, which represents a continuous immunological challenge for the organism and should be considered for the following days after drinking.

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Intestinal fatty acid-binding protein level as a predictor of 28-day mortality and bowel ischemia in patients with septic shock: A preliminary study

Cited by 43 publications

References 45 publications

The utility of brain natriuretic peptides in septic shock as markers for mortality and cardiac dysfunction: A systematic review

The utility of brain natriuretic peptides in septic shock as markers for mortality and cardiac dysfunction: A systematic review

Diagnostik der akuten Organischämie

Acute alcohol consumption increases systemic endotoxin bioactivity for days in healthy volunteers—with reduced intestinal barrier loss in female

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