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Circulating bioacti...
Circulating bioactive adrenomedullin as a marker of sepsis, septic shock and critical illness
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- Lundberg, Oscar H.M. (författare)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Lengquist, Maria (författare)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Spångfors, Martin (författare)
- Lund University,Lunds universitet,SWECRIT,Forskargrupper vid Lunds universitet,Lund University Research Groups,Central Hospital Kristianstad
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- Annborn, Martin (författare)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital
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- Bergmann, Deborah (författare)
- Sphingotec GmbH
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- Schulte, Janin (författare)
- Sphingotec GmbH
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- Levin, Helena (författare)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Melander, Olle (författare)
- Lund University,Lunds universitet,Skåne University Hospital
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- Frigyesi, Attila (författare)
- Lund University,Lunds universitet,Intensivvårdsepidemiologi,Forskargrupper vid Lunds universitet,Intensive Care Epidemiology,Lund University Research Groups,Skåne University Hospital
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- Friberg, Hans (författare)
- Lund University,Lunds universitet,SWECRIT,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- 2020-11-04
- 2020
- Engelska.
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Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535. ; 24:1
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://ccforum.biom...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: Biomarkers can be of help to understand critical illness and to identify and stratify sepsis. Adrenomedullin is a vasoactive hormone, with reported prognostic and potentially therapeutic value in sepsis. The primary aim of this study was to investigate the association of circulating bioactive adrenomedullin (bio-ADM) levels at intensive care unit (ICU) admission with mortality in sepsis patients and in a general ICU population. Secondary aims included the association of bio-ADM with organ failure and the ability of bio-ADM to identify sepsis. Methods: In this retrospective observational study, adult patients admitted to one of four ICUs during 2016 had admission bio-ADM levels analysed. Age-adjusted odds ratios (OR) with 95% CI for log-2 transformed bio-ADM, and Youden’s index derived cut-offs were calculated. The primary outcome was 30-day mortality, and secondary outcomes included the need for organ support and the ability to identify sepsis. Results: Bio-ADM in 1867 consecutive patients were analysed; 632 patients fulfilled the sepsis-3 criteria of whom 267 had septic shock. The median bio-ADM in the entire ICU population was 40 pg/mL, 74 pg/mL in sepsis patients, 107 pg/mL in septic shock and 29 pg/mL in non-septic patients. The association of elevated bio-ADM and mortality in sepsis patients and the ICU population resulted in ORs of 1.23 (95% CI 1.07–1.41) and 1.22 (95% CI 1.12–1.32), respectively. The association with mortality remained after additional adjustment for lactate in sepsis patients. Elevated bio-ADM was associated with an increased need for dialysis with ORs of 2.28 (95% CI 2.01–2.59) and 1.97 (95% CI 1.64–2.36) for the ICU population and sepsis patients, respectively, and with increased need of vasopressors, OR 1.33 (95% CI 1.23–1.42) (95% CI 1.17–1.50) for both populations. Sepsis was identified with an OR of 1.78 (95% CI 1.64–1.94) for bio-ADM, after additional adjustment for severity of disease. A bio-ADM cut-off of 70 pg/mL differentiated between survivors and non-survivors in sepsis, but a Youden’s index derived threshold of 108 pg/mL performed better. Conclusions: Admission bio-ADM is associated with 30-day mortality and organ failure in sepsis patients as well as in a general ICU population. Bio-ADM may be a morbidity-independent sepsis biomarker.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- Adrenomedullin
- Bioactive adrenomedullin
- Biomarkers
- Critical illness
- Cut-off
- Sepsis
- Septic shock
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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Lundberg, Oscar ...
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Lengquist, Maria
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Spångfors, Marti ...
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Annborn, Martin
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Bergmann, Debora ...
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Schulte, Janin
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visa fler...
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Levin, Helena
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Melander, Olle
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Frigyesi, Attila
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Friberg, Hans
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visa färre...
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- MEDICIN OCH HÄLSOVETENSKAP
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Critical Care
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Lunds universitet