Biomarkers predicting sepsis in polytrauma patients: Current evidence

Ciriello, Vincenzo; Gudipati, S.; Stavrou, Petros Z.; Kanakaris, Nikolaos K.; Bellamy, Mark; Giannoudis, Peter V.

doi:10.1016/j.injury.2013.09.024

Cited by 83 publications

(60 citation statements)

References 98 publications

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“…6 Dresing et al [26] 2004 P-coh 30 IL-6; TNF- 13% 19% 7 Egger et al [38] 2004 P-coh 26 IL-6, -8 35% 8…”

Section: Tnf-amentioning

confidence: 99%

“…Release of IL-6 is enhanced after stimulation by microorganisms and cytokines (TNF-a, IL-1β) [7,8] . It is liberated after tissue damage and infection.…”

Section: Il-6mentioning

confidence: 99%

“…A less severe initial insult may prime immune cells while eliciting a moderate inflammatory reaction. In this setting, a second insult ("hit") may strengthen the inflammatory reaction towards immune suppression, predisposing the patient to sepsis [7,8] .…”

Section: Introductionmentioning

confidence: 99%

“…After secretion, TNF-a increases endothelial cell permeability and adhesion properties, and activates macrophages, NK cells and lymphocytes. TNF-a also induces the secretion of various cytokines [IL-6, -8, -10, interferon (IFN-γ)] and immunoglobulin production [7,12] . Release of excessive TNF-a ultimately leads to accumulation of leukocytes in the injured tissues.…”

Section: Introductionmentioning

confidence: 99%

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Predictive value of cytokines for developing complications after polytrauma

Dekker

Krijnen

Schipper

2016

WJCCM

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AIM:To investigate posttraumatic cytokine alterations and their value for predicting complications and mortality in polytraumatized patients. METHODS:Studies on the use of specific cytokines to predict the development of complications and mortality were identified in MEDLINE, EMBASE, Web of Science and the Cochrane Library. Of included studies, relevant data were extracted and study quality was scored. RESULTS:Forty-two studies published between 1988 and 2015 were identified, including 28 cohort studies and 14 "nested" case-control studies. Most studies investigated the cytokines interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor (TNF-a). IL-6 seems related to muliorgan dysfunction syndrome, multiorgan failure (MOF) and mortality; IL-8 appears altered in acute respiratory distress syndrome, MOF and mortality; IL-10 alterations seem to precede sepsis and MOF; and TNF-a seems related to MOF. CONCLUSION:Cytokine secretion patterns appear to be different for patients developing complications when compared to patients with uneventful posttraumatic course. More research is needed to strengthen the evidence for clinical relevance of these cytokines.

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“…6 Dresing et al [26] 2004 P-coh 30 IL-6; TNF- 13% 19% 7 Egger et al [38] 2004 P-coh 26 IL-6, -8 35% 8…”

Section: Tnf-amentioning

confidence: 99%

“…Release of IL-6 is enhanced after stimulation by microorganisms and cytokines (TNF-a, IL-1β) [7,8] . It is liberated after tissue damage and infection.…”

Section: Il-6mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictive value of cytokines for developing complications after polytrauma

Dekker

Krijnen

Schipper

2016

WJCCM

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“…If this were so, a single, uniform critical value for PCT might be impossible to establish (11). In an extensive meta-analysis of 13 case-control studies and 17 cohort studies, Ciriello et al (15) could only show support for using PCT to predict the development of sepsis earlier among trauma patients from a wide ensemble of biomarkers (interleukin 1 [IL-1], IL-8, IL-10, neopterin, tumor necrosis factor alpha [TNF-␣], selectins, intracellular adhesion molecule 1 [ICAM-1], and Toll-like receptor 9 [TLR-9], among others). They found no value for CRP in this setting.…”

Section: Pctmentioning

confidence: 99%

Laboratory Diagnosis of Sepsis? No SIRS, Not Just Yet

Dunne

2015

J Clin Microbiol

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In order to maximize the benefit of prompt antimicrobial therapy and avoid the risk associated with inappropriate use of antimicrobial agents, patients with suspected sepsis must be rapidly differentiated from patients with systemic inflammatory response syndrome (SIRS). In combination with standard microbiological testing, a number of biomarkers have been recently evaluated for this purpose, and the performance characteristics of the most promising of these are reviewed.T he title of this minireview is somewhat misleading, because sepsis is not a laboratory diagnosis and cannot be defined (at least not yet) using any number of discrete diagnostic assays in the absence of clinical criteria. A positive blood culture, for example, regardless of the organism's identity, is useful supplemental information but does not by itself indicate a septic state. In fact, the recovery of a potential pathogen from any site (1), including blood (2), occurs in less than 50% of all cases of sepsis, and contamination of blood cultures can cloud the interpretation. From the opposite direction, it is difficult to distinguish sepsis from systemic inflammatory response syndrome (SIRS) using clinical criteria alone (3).A few definitions might help clarify the ambiguity here (4, 5). Some of these definitions have been refined over the years, but the general gist remains the same. "SIRS" was first defined in 1991 (4) and refers to "the systemic inflammatory response to a variety of severe clinical insults" (infectious or otherwise). It usually constitutes two or more of the following criteria: (i) temperature of Ͼ38°C or Ͻ36°C; (ii) heart rate of Ͼ90 beats/min; (iii) respiratory rate of Ͼ20 breaths/min or partial CO 2 pressure (pCO 2 ) of Ͻ32 mm Hg; (iv) white blood cell (WBC) count of Ͼ12,000 (12K)/l or Ͻ4K/l; or (v) Ͼ10% immature forms (i.e., bands). "Sepsis" has been defined as "the presence (probable or documented) of infection together with systemic manifestations of infection" (5). Having positive cultures supporting an infectious process adds credibility to the diagnosis but is not mandatory. Therefore, a patient can be classified as septic with Ն2 SIRS criteria and a clinical suspicion of infection without microbiological documentation. Bear this in mind when reading the remainder of this minireview. Most septic patients have SIRS, but not all SIRS patients are septic (Fig. 1). Severe sepsis adds an element of organ dysfunction or tissue hypoperfusion that is new and not explained by other causes of organ dysfunction (4). Finally, "septic shock" is "sepsis-induced hypotension persisting despite adequate fluid resuscitation" (4). Definitions specific for adult and pediatric populations are available (4-6).Sepsis is a major cause of morbidity and mortality among critically ill patients, and the management of septic shock profits from administration of early and appropriate antimicrobial therapy (7). Given that sepsis is only a subset of SIRS and that administration of antimicrobial therapy is not beneficial and indeed could generate...

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The Role of Biomarkers for the Diagnosis of Implant-Related Infections in Orthopaedics and Trauma

Alvand

Rezapoor

Parvızı

2017

Advances in Experimental Medicine and Biology

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Diagnosis of implant-related (periprosthetic joint) infections poses a major challenge to infection disease physicians and orthopaedic surgeons. Conventional diagnostic tests continue to suffer from issues of accuracy and feasibility. Biomarkers are used throughout medicine for diagnostic and prognostic purposes, as they are able to objectively determine the presence of a disease or a biological state. There is increasing evidence to support the measurement of specific biomarkers in serum and/or synovial fluid of patients with suspected periprosthetic joint infections. Promising serum biomarkers include interleukin (IL)-4, IL-6, tumour necrosis factor (TNF)-α, procalcitonin, soluble intercellular adhesion molecule 1 (sICAM-1), and D-dimer. In addition to c-reactive protein and leucocyte esterase, promising biomarkers that can be measured in synovial fluid include antimicrobial proteins such as human β-defensin (HBD)-2 and human β-defensin (HBD)-3, and cathelicidin LL-37, as well as several interleukins such as IL-1β, IL-6, IL-8, IL-17, TNF- α, interferon-δ, and vascular endothelial growth factor.

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Biomarkers predicting sepsis in polytrauma patients: Current evidence

Cited by 83 publications

References 98 publications

Predictive value of cytokines for developing complications after polytrauma

Predictive value of cytokines for developing complications after polytrauma

Laboratory Diagnosis of Sepsis? No SIRS, Not Just Yet

The Role of Biomarkers for the Diagnosis of Implant-Related Infections in Orthopaedics and Trauma

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