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Mortality. Results: 95 patients were included in the study: 49 with sepsis, 19 with severe sepsis and 27 with septic shock. 44 healthy volunteers were recruited as a matched control. D-Dimer concentration was 422 (297, 881) ng/mL in sepsis, 789 (374, 1586) ng/mL in severe sepsis and 3073 (765, 7279) ng/mL Lenvatinib in septic shock (normal range <250 ng/mL). Median EXTEM LI60 ( ) in healthy volunteers was 92 (88.3, 94). ROTEM indicated fibrinolytic function that was comparable to healthy volunteers in the sepsis and severe sepsis groups (93 (90, 95) and 91 (87, 96) respectively), but fibrinolytic function was significantly impaired in septic shock compared to all other groups (97 (95, 98), p < 0.001, Kruskal-Wallis test with Bonferroni correction). Impaired fibrinolytic function was also significantly associated with mortality (INTEM LI60 of 94 (90.5, 96) in survivors vs 96 (94.8, 96) in non-survivors, p = 0.006, Mann-Whitney U Test). Conclusions: Fibrinolytic activity was increased in patients with septic shock. However there was an impairment of the fibrinolytic function as measured by ROTEM. The exact mechanisms leading to this are not fully understood, however consumption of fibrinolytic factors could contribute as evidenced by elevated D-Dimer concentration. ROTEM lysis index (LI60) can potentially be used as a biomarker to identify PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/12711626 septic shock and as an outcome measure, although this study was not powered for outcome.Reference 1. Schouten M, et al. J Leukoc Biol. 2008;83:536-45.P034 The intensive care infection score ?a promising marker for the prediction of infection and its severity P Van der Geest1, M Mohseni1, J Linssen2, R De Jonge1, S Duran3, J Groeneveld1 1 Erasmus Medical Center, Rotterdam, Netherlands; 2University Witten/ Herdecke, Witten, Germany; 3Maasstad Ziekenhuis, Rotterdam, Netherlands Critical Care 2016, 20(Suppl 2):P034 Introduction: The prediction of infection and its severity remains difficult in critically ill patients with suspected infection1. A novel, simple biomarker derived from five blood-cell derived parameters that characterize the innate immune response in routine blood samples, the intensive care infection score (ICIS), could be helpful in this respect 2,3. We therefore compared the PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/3021955 predictive value of the ICIS with that of the white blood cell count (WBC), C-reactive protein (CRP) and procalcitonin (PCT) for infection and its severity in critically ill patients. Methods: We performed a multi-center, cluster randomized, crossover study in critically ill patients between January 2013 and September 2014. Patients with a suspected infection for which blood cultures were taken by the attending intensivist were included. Blood was taken at the same time for WBC, ICIS, CRP and PCT measurements in the study periods. Patients were divided into groups of increasing likelihood of infection and invasiveness: Group 1 without infection or with possible infection irrespective of cultures, Group 2 with probable or microbiologically proven local infection without blood stream infection (BSI) and Group 3 with BSI irrespective of local infection. Results: In total, 301 patients were enrolled with 452 suspected infection episodes (SIE), at more than 48 h intervals were analyzed. CRP, PCT and ICIS were higher in Group 2 and 3 than 1. The AUROC for the prediction of infection during the first SIE was 0.70 for CRP, 0.71 for PCT and 0.73 for ICIS (P < 0.001). For septic shock the AUROC was 0.73 for CRP, 0.85 for PCT and 0.76 for ICI.