The Level of Oxidative Neutrophil Response When Determining Endotoxin Activity Assay: A New Biomarker for Defining the Indications and Effectiveness of Intensive Care in Patients with Sepsis

Yaroustovsky, M.B.; Rogalskaya, Ekaterina; Plyushch, Marina; Klimovich, Ludmila; Самсонова, Н. Н.; Abramyan, Marina

doi:10.1155/2017/3495293

Cited by 5 publications

(4 citation statements)

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“…The inclusion of “response” and PSP values in laboratory studies as a whole increases the information content of the entire cohort of laboratory studies and the efficiency of therapy [24]. The algorithm of the National Center of Cardiovascular Surgery for applying laboratory tests to define indications for selective adsorption of endotoxin in patients with sepsis, induced by Gram-negative pathogens, consists of several points.…”

Section: Discussionmentioning

confidence: 99%

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Selective Polymyxin Hemoperfusion in Complex Therapy of Sepsis in Children after Cardiac Surgery

et al. 2020

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Background: To date, sepsis remains one of the main challenges of intensive care in pediatrics. Newborns with low birth weight and infants with chronic diseases and congenital disorders are particularly at risk. The incidence of infectious complications in pediatric cardiac surgery is known to be approximately 15–30%. The main etiological factor of sepsis is endotoxin. Aim: To evaluate the efficiency and safety of polymyxin (PMX) B-immobilized column-direct hemoperfusion in complex intensive therapy of sepsis in children after cardiac surgery with cardiopulmonary bypass. Design: Prospective cohort study. Methods: This study enrolled 15 children, aged 9–96 months, with congenital heart diseases and with body weights of 6.2–22.5 kg. The criteria for admission were body weight >6 kg and clinical and laboratory signs of sepsis (microbiological analysis, procalcitonin [PCT] >2 ng/mL, and endotoxin activity assay [ЕАА] >0.6). Intensive care included inotropic and vasopressor support, mechanical ventilation, broad-spectrum antibiotic therapy, and PMX hemoperfusion procedures. Extracorporeal therapy was initiated within 24 h following the sepsis diagnosis. Every patient underwent 2 hemoperfusion sessions with the use of a PMX B-immobilized column; the session duration was 180 min. Results: We noted improvements in hemodynamic parameters, oxygenation index, and laboratory signs of sepsis, with decreases in the endotoxin concentration according to the EAA, PCT, and presepsin levels. The 28-day survival of the patients in this severely affected group was 80%. Main Conclusion: The inclusion of extracorporeal methods of blood purification, aimed at the selective elimination of circulating endotoxin, in the treatment of sepsis increases the survival rates of children after open heart surgery. Second Conclusion: The obtained results of sepsis therapy with PMX hemoperfusion in children after cardiac surgery enable us to suggest the sufficient safety and efficiency of the procedures in this category of severely affected patients.

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Section: Discussionmentioning

confidence: 99%

“…It is necessary to precisely determine the endotoxemia level to evaluate the efficiency of the selective PMX hemoperfusion in the complex treatment of septic conditions [8,11,[20][21][22][23][24]. At present, the number of tests allowing the detection of the endotoxemia level at the patient's bedside in real time is low.…”

Section: Introductionmentioning

confidence: 99%

Selective Polymyxin Hemoperfusion in Complex Therapy of Sepsis in Children after Cardiac Surgery

et al. 2020

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“…Данный факт подтверждается нашими исследованиями (см. рис 3), наличием умеренной отрицательной связи response и концентрации ЛПС -r=-0,87, р<0,001, а также зарубежным исследованием [25]. По мере прогрессирования тяжести эндотоксинемии показатель EAA может не совсем адекватно отражать тяжесть эндотоксиновой нагрузки.…”

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The state of the immune system in abdominal sepsis

Кошелев

Vatazin

Zulkarnayev

et al. 2019

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Sepsis is a serious condition characterized by a complex dysfunction of internal organs and systems. In the basis of the pathogenesis of sepsis, the leading role is played by the dysregulation of the immune response to the infectious agent, in particular endotoxin of gramnegative bacteria, which is an obligate lipopolysaccharide of the bacterial wall. Aim. To evaluate the prognostic value of cytokine profile, phagocytosis activity indices, endotoxin concentration and activity in blood in gram-negative sepsis. Materials and methods. 78 patients with abdominal sepsis were included in a one-center prospective cohort study, of them 45 died. All the patients were evaluated for the concentration of circulating cytokines (TNF-α, IFN-γ, IL-6, IL-8, IL-10), cellular molecules (CD3, CD45RO, CD95 and HLA-DR), bactericidal and phagocytic activity of neutrophils and endotoxin (lipopolysaccharide) level in peripheral blood. Results and discussion. The concentrations of all cytokines were slightly lower in the survivors. Significant differences were noted for TNF-α (p=0.001), IL-6 (p=0.001), and IL-8 (p=0.007). The expression of HLA-DR molecules was slightly higher (p=0.055), and CD95 was lower (p=0.146) in survivors than in the dead. However, the differences have not reached the required level of statistical significance. The phagocytic (p

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“…Procalcitonin (PCT) is a protein that reflects the activity of the body's inflammatory response (4). High expression occurs in sepsis, shock, and multiple organ dysfunctions (5,6).…”

Section: Introductionmentioning

confidence: 99%

Application value of procalcitonin, C‑reactive protein and interleukin‑6 in the evaluation of traumatic shock

et al. 2019

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Procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) were detected to explore the value of these inflammatory markers in the assessment of traumatic shock patients. The clinical data of 80 patients with traumatic shock and infections in Zhangzhou Municipal Hospital of Fujian Province from January 2014 to December 2017 were collected as the experimental group. During the same period, 80 acute trauma patients who did not suffer from traumatic shock were regarded as the control group. According to the prognosis outcomes, the experimental group was divided into 56 patients with good prognosis and 24 patients with poor prognosis. Also the PCT, CRP and IL-6 levels in serum of patients at admission (T1), 12 h after admission (T2), three days after admission (T3) and on day 7 (T4) were detected. The differences between the three inflammatory indicators, the pre-admission injury severity score (ISS score), the acute physiology and chronic psychological score (APACHE II score) were compared between the good prognosis and the poor prognosis group. The serum CRP at the T4 time period was significantly lower than both the T1 and T2 time periods (P<0.05). There were differences in serum PCT, CRP and IL-6 between the good prognosis and the poor prognosis group at the time of T1-T4 (P<0.05). The expression levels of PCT, CRP and IL-6 in the serum of patients with poor prognosis were higher than those with good prognosis (P<0.05). Pre-admission ISS scores and APACHE II scores in patients with good prognosis were lower than those with poor prognosis (P<0.05). Detection of PCT, CRP and IL-6 expression levels in serum of the patients has an important reference value for assessing the condition of patients with traumatic shock.

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The Level of Oxidative Neutrophil Response When Determining Endotoxin Activity Assay: A New Biomarker for Defining the Indications and Effectiveness of Intensive Care in Patients with Sepsis

Cited by 5 publications

References 22 publications

Selective Polymyxin Hemoperfusion in Complex Therapy of Sepsis in Children after Cardiac Surgery

Selective Polymyxin Hemoperfusion in Complex Therapy of Sepsis in Children after Cardiac Surgery

The state of the immune system in abdominal sepsis

Application value of procalcitonin, C‑reactive protein and interleukin‑6 in the evaluation of traumatic shock

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