Circulating protein and lipid markers of early sepsis diagnosis and prognosis: a scoping review

Barber, Gemma; Tanic, Jelena; Leligdowicz, Aleksandra

doi:10.1097/mol.0000000000000870

Cited by 6 publications

(3 citation statements)

References 127 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 36 Barber et al also found that low HDL is associated with poor outcome in sepsis. 37 We recommend the utility of plasma TG as a prognostic marker. Lipid mediators play an important role in the proinflammatory and counter-regulatory anti-inflammatory changes in the microvasculature in sepsis.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of laboratory indicators for in-hospital death in children with community-onset sepsis: a prospective observational study of 266 patients

Liu,

Hui,

et al. 2024

bmjpo

View full text Add to dashboard Cite

Background and objectivesThis study aimed to identify predictors of sepsis-associated in-hospital mortality from readily available laboratory biomarkers at onset of illness that include haematological, coagulation, liver and kidney function, blood lipid, cardiac enzymes and arterial blood gas.MethodsChildren with sepsis were enrolled consecutively in a prospective observational study involving paediatric intensive care units (PICUs) of two hospitals in Beijing, between November 2016 and January 2020. The data on demographics, laboratory examinations during the first 24 hours after PICU admission, complications and outcomes were collected. We screened baseline laboratory indicators using the Least Absolute Shrinkage and Selection Operator (LASSO) analysis, then we constructed a mortality risk model using Cox proportional hazards regression analysis. The ability of risk factors to predict in-hospital mortality was evaluated by receiver operating characteristic (ROC) curves.ResultsA total of 266 subjects were enrolled including 44 (16.5%) deaths and 222 (83.5%) survivors. Those who died showed a shorter length of hospitalisation, and a higher proportion of mechanical ventilation, complications and organ failure (p<0.05). LASSO analysis identified 13 clinical parameters related to prognosis, which were included in the final Cox model. An elevated triglyceride (TG) remained the most significant risk factor of death (HR=1.469, 95% CI: 1.010 to 2.136, p=0.044), followed by base excess (BE) (HR=1.131, 95% CI: 1.046 to 1.223, p=0.002) and pH (HR=0.95, 95% CI: 0.93 to 0.97, p<0.001). The results of the ROC curve showed that combined diagnosis of the three indicators—TG+BE+pH—has the best area under the curve (AUC) (AUC=0.77, 95% CI: 0.69 to 0.85, p<0.001), with a 68% sensitivity and 80% specificity.ConclusionLaboratory factors of TG, BE and pH during the first 24 hours after intensive care unit admission are associated with in-hospital mortality in PICU patients with sepsis. The combination of the three indices has high diagnostic value.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictive value of laboratory indicators for in-hospital death in children with community-onset sepsis: a prospective observational study of 266 patients

Liu,

Hui,

et al. 2024

bmjpo

View full text Add to dashboard Cite

show abstract

“…The rapid progression and high mortality of sepsis implies the necessity of identifying prognostic indicators associated with its outcome. It is recommended that scholars further explore serum markers and prognostic correlates to help clinicians intervene early [16,17] . Calcium is an essential trace element in the human body that is responsible for physiological functions including cell signaling, neurotransmission, and muscle contraction [6,18,19] .…”

Section: Discussionmentioning

confidence: 99%

Nonlinear relationship between ionized calcium and 28-day mortality in patients with sepsis: A retrospective cohort study from MIMIC-IV database

Liang,

Chen,

Zhou

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: This study aimed to investigate the linear and nonlinear relationships between ionized calcium levels and 28-day mortality in patients with sepsis in the intensive care unit (ICU) and to provide clinicians with a direction for laboratory index testing and a basis for a calcium supplementation program. Methods: The data of patients with sepsis were extracted from the Medical Information Mart for Intensive Care (MIMIC-IV;) database, iCa served as the exposure variable, and 28-day mortality served as the outcome variable. The relationship between iCa and 28-day mortality was investigated using multivariate binary logistic regression models, with adjustment for covariates. A generalized additive model (GAM) and smoothed curve fitting were used to investigate the non-linear relationship between iCa and 28-day mortality. A two-piecewise linear model was used to calculate the OR and 95% CI on either side of the inflection point. Results: Patients with sepsis (n = 20,417) were included in the analysis, with an overall 28-day mortality rate of 19.73%. Sepsis patients were grouped into quartiles (Q1 - Q4) according to ionized calcium levels, and after complete adjustment, the short-term mortality rate of sepsis patients in Q2 - Q4 was significantly lower than that in the Q1 group (OR:0.78, 95% CI: 0.70 - 0.87. OR: 0.74, 95% CI: 0.66 - 0.83. OR: 0.81, 95% CI: 0.72 - 0.9. iCa and 28-day mortality displayed a U-shaped relationship among patients with sepsis. When iCa levels were less than 1.14 mmol/L, each unit increase corresponded to a 79% reduction in the risk of 28-day sepsis mortality(OR: 0.21, 95% CI: 0.13 - 0.35). Conversely, when iCa exceeded 1.14 mmol/L, each unit increase was linked to an 85% increase in the 28-day mortality risk (OR: 1.85, 95% CI: 1.08 - 3.16). Conclusion: The relationship between iCa and 28-day mortality in patients with sepsis showed a U-shaped curve with an inflection point of 1.14 mmol/L, which is in the range of mild hypocalcemia.

show abstract

“…On the other hand, it enhances endothelial cell permeability in many parts of the body, thereby assisting inflammatory cell migration to and aggregation at the infection source. 11 However, excessive HBP leads to vascular leakage, edema, and immune disorder in severe infections. 12,13 Increased levels of HBP in peripheral blood have been reported as a common feature of patients with sepsis.…”

Section: Introductionmentioning

confidence: 99%

Heparin-Binding Protein Promotes Acute Lung Injury in Sepsis Mice by Blocking the Aryl Hydrocarbon Receptor Signaling Pathway

Ye,

Lin,

Chen

et al. 2024

JIR

View full text Add to dashboard Cite

This study aimed to explore the therapeutic effect and potential mechanism of heparin-binding protein (HBP) reduction on sepsis-related acute lung injury. Methods: We utilized a murine model of sepsis-induced by intraperitoneal injection of lipopolysaccharides (LPS) in C57BL/6J mice divided into four groups: Control, LPS, Anti-HBP, and ceftriaxone (CEF). Following sepsis induction, Anti-HBP or CEF treatments were administered, and survival rates were monitored for 48 h. We then used reverse-transcription quantitative PCR to analyze the expression levels of HBP in lung tissues, immunohistochemistry for protein localization, and Western blotting for protein quantification. Pulmonary inflammation was assessed using enzyme-linked immunosorbent assays of proinflammatory cytokines (tumor necrosis factor-α, interleukin [IL]-1β, IL-6, and interferon-γ). The activation state of the aryl hydrocarbon receptor (AhR) signaling pathway was determined via Western blotting, evaluating both cytoplasmic and nuclear localization of AhR and the expression of cytochrome P450 1A1 protein by its target gene. Results: Anti-HBP specifically reduced HBP levels. The survival rate of mice in the Anti-HBP and CEF groups was much higher than that in the LPS group. The severity of lung injury and pulmonary inflammatory response in the Anti-HBP and CEF groups was significantly lower than that in the LPS group. AhR signaling pathway activation was observed in the Anti-HBP and CEF groups. Additionally, there was no significant difference in the above indices between the Anti-HBP and CEF groups. Conclusion: HBP downregulation in lung tissues significantly improved LPS-induced lung injury and the pulmonary inflammatory response, thereby prolonging the survival of sepsis mice, suggesting activation of the AhR signaling pathway. Moreover, the effect of lowering the HBP level was equivalent to that of the classical antibiotic CEF. Trial Registration: Not applicable.

show abstract

Circulating protein and lipid markers of early sepsis diagnosis and prognosis: a scoping review

Cited by 6 publications

References 127 publications

Predictive value of laboratory indicators for in-hospital death in children with community-onset sepsis: a prospective observational study of 266 patients

Predictive value of laboratory indicators for in-hospital death in children with community-onset sepsis: a prospective observational study of 266 patients

Nonlinear relationship between ionized calcium and 28-day mortality in patients with sepsis: A retrospective cohort study from MIMIC-IV database

Heparin-Binding Protein Promotes Acute Lung Injury in Sepsis Mice by Blocking the Aryl Hydrocarbon Receptor Signaling Pathway

Contact Info

Product

Resources

About