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Erschienen in: Intensive Care Medicine 3/2016

01.03.2016 | What's New in Intensive Care

What’s new with biomarker-driven clinical strategy in sepsis and circulatory failure?

verfasst von: Armand Mekontso Dessap, Lorraine B. Ware, Lila Bouadma

Erschienen in: Intensive Care Medicine | Ausgabe 3/2016

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Excerpt

Biomarkers are increasingly used in modern medicine. Troponin monitoring for acute coronary syndrome is a good example of widespread biomarker-driven clinical strategy. However, in intensive care unit (ICU) patients, the cardiac ischemic origin and clinical implications of elevated troponin are unclear, although this biomarker may be of help in identifying septic patients with sepsis-induced myocardial dysfunction and/or a risk of death [1]. Only a few biomarkers have proved useful to drive clinical strategies in acutely ill patients. We will examine the main recent findings in this era in ICU patients with sepsis or circulatory failure. …
Literatur
1.
Zurück zum Zitat Bessiere F, Khenifer S, Dubourg J, Durieu I, Lega JC (2013) Prognostic value of troponins in sepsis: a meta-analysis. Intensive Care Med 39:1181–1189CrossRefPubMed Bessiere F, Khenifer S, Dubourg J, Durieu I, Lega JC (2013) Prognostic value of troponins in sepsis: a meta-analysis. Intensive Care Med 39:1181–1189CrossRefPubMed
2.
Zurück zum Zitat Uzzan B, Cohen R, Nicolas P, Cucherat M, Perret GY (2006) Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Crit Care Med 34:1996–2003CrossRefPubMed Uzzan B, Cohen R, Nicolas P, Cucherat M, Perret GY (2006) Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Crit Care Med 34:1996–2003CrossRefPubMed
3.
Zurück zum Zitat Heyland DK, Johnson AP, Reynolds SC, Muscedere J (2011) Procalcitonin for reduced antibiotic exposure in the critical care setting: a systematic review and an economic evaluation. Crit Care Med 39:1792–1799CrossRefPubMed Heyland DK, Johnson AP, Reynolds SC, Muscedere J (2011) Procalcitonin for reduced antibiotic exposure in the critical care setting: a systematic review and an economic evaluation. Crit Care Med 39:1792–1799CrossRefPubMed
4.
Zurück zum Zitat Shehabi Y, Sterba M, Garrett PM, Rachakonda KS, Stephens D, Harrigan P, Walker A, Bailey MJ, Johnson B, Millis D, Ding G, Peake S, Wong H, Thomas J, Smith K, Forbes L, Hardie M, Micallef S, Fraser JF (2014) Procalcitonin algorithm in critically ill adults with undifferentiated infection or suspected sepsis. A randomized controlled trial. Am J Respir Crit Care Med 190:1102–1110CrossRefPubMed Shehabi Y, Sterba M, Garrett PM, Rachakonda KS, Stephens D, Harrigan P, Walker A, Bailey MJ, Johnson B, Millis D, Ding G, Peake S, Wong H, Thomas J, Smith K, Forbes L, Hardie M, Micallef S, Fraser JF (2014) Procalcitonin algorithm in critically ill adults with undifferentiated infection or suspected sepsis. A randomized controlled trial. Am J Respir Crit Care Med 190:1102–1110CrossRefPubMed
5.
Zurück zum Zitat Jensen JU, Hein L, Lundgren B, Bestle MH, Mohr TT, Andersen MH, Thornberg KJ, Loken J, Steensen M, Fox Z, Tousi H, Soe-Jensen P, Lauritsen AO, Strange D, Petersen PL, Reiter N, Hestad S, Thormar K, Fjeldborg P, Larsen KM, Drenck NE, Ostergaard C, Kjaer J, Grarup J, Lundgren JD (2011) Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial. Crit Care Med 39:2048–2058CrossRefPubMed Jensen JU, Hein L, Lundgren B, Bestle MH, Mohr TT, Andersen MH, Thornberg KJ, Loken J, Steensen M, Fox Z, Tousi H, Soe-Jensen P, Lauritsen AO, Strange D, Petersen PL, Reiter N, Hestad S, Thormar K, Fjeldborg P, Larsen KM, Drenck NE, Ostergaard C, Kjaer J, Grarup J, Lundgren JD (2011) Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial. Crit Care Med 39:2048–2058CrossRefPubMed
6.
Zurück zum Zitat Schuetz P, Balk R, Briel M, Kutz A, Christ-Crain M, Stolz D, Bouadma L, Wolff M, Kristoffersen KB, Wei L, Burkhardt O, Welte T, Schroeder S, Nobre V, Tamm M, Bhatnagar N, Bucher HC, Luyt CE, Chastre J, Tubach F, Mueller B, Lacey MJ, Ohsfeldt RL, Scheibling CM, Schneider JE (2015) Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a US health system perspective. Clin Chem Lab Med 53:583–592PubMed Schuetz P, Balk R, Briel M, Kutz A, Christ-Crain M, Stolz D, Bouadma L, Wolff M, Kristoffersen KB, Wei L, Burkhardt O, Welte T, Schroeder S, Nobre V, Tamm M, Bhatnagar N, Bucher HC, Luyt CE, Chastre J, Tubach F, Mueller B, Lacey MJ, Ohsfeldt RL, Scheibling CM, Schneider JE (2015) Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a US health system perspective. Clin Chem Lab Med 53:583–592PubMed
7.
Zurück zum Zitat Suberviola B, Castellanos-Ortega A, Ruiz Ruiz A, Lopez-Hoyos M, Santibanez M (2013) Hospital mortality prognostication in sepsis using the new biomarkers suPAR and proADM in a single determination on ICU admission. Intensive Care Med 39:1945–1952CrossRefPubMed Suberviola B, Castellanos-Ortega A, Ruiz Ruiz A, Lopez-Hoyos M, Santibanez M (2013) Hospital mortality prognostication in sepsis using the new biomarkers suPAR and proADM in a single determination on ICU admission. Intensive Care Med 39:1945–1952CrossRefPubMed
8.
Zurück zum Zitat Gibot S, Bene MC, Noel R, Massin F, Guy J, Cravoisy A, Barraud D, De Carvalho Bittencourt M, Quenot JP, Bollaert PE, Faure G, Charles PE (2012) Combination biomarkers to diagnose sepsis in the critically ill patient. Am J Respir Crit Care Med 186:65–71CrossRefPubMed Gibot S, Bene MC, Noel R, Massin F, Guy J, Cravoisy A, Barraud D, De Carvalho Bittencourt M, Quenot JP, Bollaert PE, Faure G, Charles PE (2012) Combination biomarkers to diagnose sepsis in the critically ill patient. Am J Respir Crit Care Med 186:65–71CrossRefPubMed
9.
Zurück zum Zitat Casserly B, Phillips GS, Schorr C, Dellinger RP, Townsend SR, Osborn TM, Reinhart K, Selvakumar N, Levy MM (2015) Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database. Crit Care Med 43:567–573CrossRefPubMed Casserly B, Phillips GS, Schorr C, Dellinger RP, Townsend SR, Osborn TM, Reinhart K, Selvakumar N, Levy MM (2015) Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database. Crit Care Med 43:567–573CrossRefPubMed
10.
Zurück zum Zitat Nguyen HB, Rivers EP, Knoblich BP, Jacobsen G, Muzzin A, Ressler JA, Tomlanovich MC (2004) Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med 32:1637–1642CrossRefPubMed Nguyen HB, Rivers EP, Knoblich BP, Jacobsen G, Muzzin A, Ressler JA, Tomlanovich MC (2004) Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med 32:1637–1642CrossRefPubMed
11.
Zurück zum Zitat Jansen TC, van Bommel J, Schoonderbeek FJ, Sleeswijk Visser SJ, van der Klooster JM, Lima AP, Willemsen SP, Bakker J (2010) Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial. Am J Respir Crit Care Med 182:752–761CrossRefPubMed Jansen TC, van Bommel J, Schoonderbeek FJ, Sleeswijk Visser SJ, van der Klooster JM, Lima AP, Willemsen SP, Bakker J (2010) Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial. Am J Respir Crit Care Med 182:752–761CrossRefPubMed
12.
Zurück zum Zitat Jones AE, Shapiro NI, Trzeciak S, Arnold RC, Claremont HA, Kline JA (2010) Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA 303:739–746CrossRefPubMedPubMedCentral Jones AE, Shapiro NI, Trzeciak S, Arnold RC, Claremont HA, Kline JA (2010) Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA 303:739–746CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat van Beest PA, Lont MC, Holman ND, Loef B, Kuiper MA, Boerma EC (2013) Central venous-arterial pCO2 difference as a tool in resuscitation of septic patients. Intensive Care Med 39:1034–1039CrossRefPubMed van Beest PA, Lont MC, Holman ND, Loef B, Kuiper MA, Boerma EC (2013) Central venous-arterial pCO2 difference as a tool in resuscitation of septic patients. Intensive Care Med 39:1034–1039CrossRefPubMed
14.
Zurück zum Zitat Mekontso-Dessap A, Castelain V, Anguel N, Bahloul M, Schauvliege F, Richard C, Teboul JL (2002) Combination of venoarterial PCO2 difference with arteriovenous O2 content difference to detect anaerobic metabolism in patients. Intensive Care Med 28:272–277CrossRefPubMed Mekontso-Dessap A, Castelain V, Anguel N, Bahloul M, Schauvliege F, Richard C, Teboul JL (2002) Combination of venoarterial PCO2 difference with arteriovenous O2 content difference to detect anaerobic metabolism in patients. Intensive Care Med 28:272–277CrossRefPubMed
15.
Zurück zum Zitat Ospina-Tascon GA, Umana M, Bermudez W, Bautista-Rincon DF, Hernandez G, Bruhn A, Granados M, Salazar B, Arango-Davila C, De Backer D (2015) Combination of arterial lactate levels and venous-arterial CO to arterial-venous O content difference ratio as markers of resuscitation in patients with septic shock. Intensive Care Med 41:796–805CrossRefPubMedPubMedCentral Ospina-Tascon GA, Umana M, Bermudez W, Bautista-Rincon DF, Hernandez G, Bruhn A, Granados M, Salazar B, Arango-Davila C, De Backer D (2015) Combination of arterial lactate levels and venous-arterial CO to arterial-venous O content difference ratio as markers of resuscitation in patients with septic shock. Intensive Care Med 41:796–805CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat De Backer D, Ospina-Tascon G, Salgado D, Favory R, Creteur J, Vincent JL (2010) Monitoring the microcirculation in the critically ill patient: current methods and future approaches. Intensive Care Med 36:1813–1825CrossRefPubMed De Backer D, Ospina-Tascon G, Salgado D, Favory R, Creteur J, Vincent JL (2010) Monitoring the microcirculation in the critically ill patient: current methods and future approaches. Intensive Care Med 36:1813–1825CrossRefPubMed
17.
Zurück zum Zitat Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, Jaeschke R, Mebazaa A, Pinsky MR, Teboul JL, Vincent JL, Rhodes A (2014) Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med 40:1795–1815CrossRefPubMedPubMedCentral Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, Jaeschke R, Mebazaa A, Pinsky MR, Teboul JL, Vincent JL, Rhodes A (2014) Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med 40:1795–1815CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Mickiewicz B, Duggan GE, Winston BW, Doig C, Kubes P, Vogel HJ (2014) Metabolic profiling of serum samples by 1H nuclear magnetic resonance spectroscopy as a potential diagnostic approach for septic shock. Crit Care Med 42:1140–1149CrossRefPubMed Mickiewicz B, Duggan GE, Winston BW, Doig C, Kubes P, Vogel HJ (2014) Metabolic profiling of serum samples by 1H nuclear magnetic resonance spectroscopy as a potential diagnostic approach for septic shock. Crit Care Med 42:1140–1149CrossRefPubMed
Metadaten
Titel
What’s new with biomarker-driven clinical strategy in sepsis and circulatory failure?
verfasst von
Armand Mekontso Dessap
Lorraine B. Ware
Lila Bouadma
Publikationsdatum
01.03.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 3/2016
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-015-4058-9

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