Diagnostic value of sepsis markers at the stages of intensive care
https://doi.org/10.31549/2542-1174-2018-4-34-41
Abstract
The informativeness of existing diagnostic markers of sepsis at various stages of its development remains controversial. The aim of the study was to assess the diagnostic significance of peripheral blood cell composition, some biochemical tests, as well as modern sepsis markers. 54 patients aged 20 to 70 years with verified abdominal sepsis participated in the study. The results obtained indicate a low diagnostic value of such indicators as leukocytosis and the appearance of immature forms of leukocytes. The lymphocytic index is the most informative (100 %) diagnostic criterion for sepsis at all stages of observation regardless of severity, timing and presence hemodynamic disorders. The diagnostic value of acute phase proteins of procalcitonin and C-reactive protein upon admission to the hospital was 64 % and 82 % respectively. The high concentration of IL1-Ra (1000-6000 pg/ml) can be regarded as a predictor of mortality.
Keywords
IL1-Ra,
sepsis,
diagnostics,
lymphopenia,
cytokines,
C-reactive protein,
procalcitonin,
IL1-Ra,
lymphocytic index
About the Authors
V. A. Valeeva
Novosibirsk State Medical University
Russian Federation
Russian Federation
E. I. Streltsova
Novosibirsk State Medical University; Novosibirsk State Regional Clinical Hospital
Russian Federation
Russian Federation
E. I. Vereshchagin
Novosibirsk State Medical University
Russian Federation
Russian Federation
References
1. Slade E., Tamber P.S., Vincent J.L. The Surviving Sepsis Campaign: raising awareness to reduce mortality // Crit. Care. 2003. Vol. 7 (1). P. 1-2.
2. Becker K.L., Snider R., Nylen E.S. Procalcitonin assay in systemic inflammation, infection, and sepsis: clinical utility and limitations // Crit. Care Med. 2008. Vol. 36 (3). P. 941-952.
3. Korczowski B., Malek U., Kowalczyk J.R. et al. Two diagnostic assays for serum procalcitonin measurement in clinical practice // Przegl. Lek. 2003. Vol. 60 (5). P. 345-348.
4. Flood R.G., Badik J., Aronoff S.C. The utility of serum C-reactive protein in differentiating bacterial from nonbacterial pneumonia in children: a meta-analysis of 1230 children // Pediatr. Infect. Dis. J. 2008. Vol. 27 (2). P. 95-99.
5. Flanders S.A., Stein J., Shochat G. et al. Performance of a bedside C-reactive protein test in the diagnosis of community-acquired pneumonia in adults with acute cough // Am. J. Med. 2004. Vol. 116 (8). P. 529-535.
6. Островский В.К., Мащенко А.В., Янголенко Д.В., Макаров С.В. Показатели крови и лейкоцитарного индекса интоксикации в оценке тяжести и определении прогноза при воспалительных, гнойных и гнойно-деструктивных заболеваниях // Анестезиология и реаниматология. 2005. Т. 6. С. 25-29.
7. Drewry А., Samra N., Skrupky L. et al. Persistent lymphopenia after diagnosis of sepsis predicts morta-lity // Shock. 2014 Nov. Vol. 42 (5). P. 383-391.
8. Хаертынов Х.С., Анохин В.А., Бойчук С.В., Ризванов А.А. Сепсис и апоптоз // Гены и клетки. 2016. Т. 11, № 4. С. 18-21.
9. Lewis R.T., Klein H. Risk factors in postoperative sepsis: significance of preoperative lymphocytopenia // J. Surg. Res. 1979. Vol. 26 (4). P. 365-371.
10. de Jager C., van Wijk P., Mathoera R.B. et al. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit // Crit. Care. 2010. Vol. 14 (5): R192.
11. Muller B., Becker K.L., Schachinger H. et al. Calcitonin precursors are reliable markers of sepsis in medical intensive care unit // Crit. Care Med. 2000. Vol. 28 (4). P. 977-983
Review
For citations:
Valeeva V.A., Streltsova E.I., Vereshchagin E.I. Diagnostic value of sepsis markers at the stages of intensive care. Journal of Siberian Medical Sciences. 2018;(4):34-41. (In Russ.) https://doi.org/10.31549/2542-1174-2018-4-34-41
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