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Heparin-binding protein: an early marker of circulatory failure in sepsis.

Linder, Adam LU ; Christensson, Bertil LU ; Herwald, Heiko LU ; Björck, Lars LU and Åkesson, Per LU (2009) In Clinical Infectious Diseases 49(7). p.1044-1050
Abstract
BACKGROUND: The early detection of circulatory failure in patients with sepsis is important for successful treatment. Heparin-binding protein (HBP), released from activated neutrophils, is a potent inducer of vascular leakage. In this study, we investigated whether plasma levels of HBP could be used as an early diagnostic marker for severe sepsis with hypotension. METHODS: A prospective study of 233 febrile adult patients with a suspected infection was conducted. Patients were classified into 5 groups on the basis of systemic inflammatory response syndrome criteria, organ failure, and the final diagnosis. Blood samples obtained at enrollment were analyzed for the concentrations of HBP, procalcitonin, interleukin-6, lactate, C-reactive... (More)
BACKGROUND: The early detection of circulatory failure in patients with sepsis is important for successful treatment. Heparin-binding protein (HBP), released from activated neutrophils, is a potent inducer of vascular leakage. In this study, we investigated whether plasma levels of HBP could be used as an early diagnostic marker for severe sepsis with hypotension. METHODS: A prospective study of 233 febrile adult patients with a suspected infection was conducted. Patients were classified into 5 groups on the basis of systemic inflammatory response syndrome criteria, organ failure, and the final diagnosis. Blood samples obtained at enrollment were analyzed for the concentrations of HBP, procalcitonin, interleukin-6, lactate, C-reactive protein, and the number of white blood cells. RESULTS: Twenty-six patients were diagnosed with severe sepsis and septic shock, 44 patients had severe sepsis without septic shock, 100 patients had sepsis, 43 patients had an infection without sepsis, and 20 patients had an inflammatory response caused by a noninfectious disease. A plasma HBP level > or = 15 ng/mL was a better indicator of severe sepsis (with or without septic shock) than any other laboratory parameter investigated (sensitivity, 87.1%; specificity, 95.1%; positive predictive value, 88.4%; negative predictive value, 94.5%). Thirty-two of the 70 patients with severe sepsis were sampled for up to 12 h before signs of circulatory failure appeared, and in 29 of these patients, HBP plasma concentrations were already elevated. CONCLUSION: In febrile patients, high plasma levels of HBP help to identify patients with an imminent risk of developing sepsis with circulatory failure. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Infectious Diseases
volume
49
issue
7
pages
1044 - 1050
publisher
The Infectious Diseases Society of America
external identifiers
  • wos:000269672300009
  • pmid:19725785
  • scopus:70349929473
ISSN
1537-6591
DOI
10.1086/605563
language
English
LU publication?
yes
id
421a6e21-48f2-4e5f-ace5-7940c30243df (old id 1483905)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19725785?dopt=Abstract
date added to LUP
2009-10-05 15:15:50
date last changed
2017-11-05 04:43:10
@article{421a6e21-48f2-4e5f-ace5-7940c30243df,
  abstract     = {BACKGROUND: The early detection of circulatory failure in patients with sepsis is important for successful treatment. Heparin-binding protein (HBP), released from activated neutrophils, is a potent inducer of vascular leakage. In this study, we investigated whether plasma levels of HBP could be used as an early diagnostic marker for severe sepsis with hypotension. METHODS: A prospective study of 233 febrile adult patients with a suspected infection was conducted. Patients were classified into 5 groups on the basis of systemic inflammatory response syndrome criteria, organ failure, and the final diagnosis. Blood samples obtained at enrollment were analyzed for the concentrations of HBP, procalcitonin, interleukin-6, lactate, C-reactive protein, and the number of white blood cells. RESULTS: Twenty-six patients were diagnosed with severe sepsis and septic shock, 44 patients had severe sepsis without septic shock, 100 patients had sepsis, 43 patients had an infection without sepsis, and 20 patients had an inflammatory response caused by a noninfectious disease. A plasma HBP level > or = 15 ng/mL was a better indicator of severe sepsis (with or without septic shock) than any other laboratory parameter investigated (sensitivity, 87.1%; specificity, 95.1%; positive predictive value, 88.4%; negative predictive value, 94.5%). Thirty-two of the 70 patients with severe sepsis were sampled for up to 12 h before signs of circulatory failure appeared, and in 29 of these patients, HBP plasma concentrations were already elevated. CONCLUSION: In febrile patients, high plasma levels of HBP help to identify patients with an imminent risk of developing sepsis with circulatory failure.},
  author       = {Linder, Adam and Christensson, Bertil and Herwald, Heiko and Björck, Lars and Åkesson, Per},
  issn         = {1537-6591},
  language     = {eng},
  number       = {7},
  pages        = {1044--1050},
  publisher    = {The Infectious Diseases Society of America},
  series       = {Clinical Infectious Diseases},
  title        = {Heparin-binding protein: an early marker of circulatory failure in sepsis.},
  url          = {http://dx.doi.org/10.1086/605563},
  volume       = {49},
  year         = {2009},
}