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Repeated measures of Heparin-binding protein (HBP) and procalcitonin during septic shock : biomarker kinetics and association with cardiovascular organ dysfunction

Tverring, Jonas LU orcid ; Nielsen, Niklas LU ; Dankiewicz, Josef LU orcid ; Linder, Adam LU ; Kahn, Fredrik LU and Åkesson, Per LU (2020) In Intensive Care Medicine Experimental 8(1).
Abstract

BACKGROUND: Heparin-binding protein (HBP) is a neutrophil-derived pro-inflammatory protein, an inducer of endothelial dysfunction and vascular permeability and a promising prognostic biomarker in sepsis. This exploratory study aims to describe the kinetics of plasma HBP during septic shock and investigate an association between repeated measures of HBP concentration and cardiovascular organ dysfunction severity.

METHODS: We included patients at or above 18 years with suspected septic shock on admission to the intensive care unit (ICU) during 2014 and 2016 to 2018. Plasma samples were collected from ICU admission and every 4 h for 72 h or until death or ICU discharge and batch analysed for HBP. Mean arterial blood pressure (MAP)... (More)

BACKGROUND: Heparin-binding protein (HBP) is a neutrophil-derived pro-inflammatory protein, an inducer of endothelial dysfunction and vascular permeability and a promising prognostic biomarker in sepsis. This exploratory study aims to describe the kinetics of plasma HBP during septic shock and investigate an association between repeated measures of HBP concentration and cardiovascular organ dysfunction severity.

METHODS: We included patients at or above 18 years with suspected septic shock on admission to the intensive care unit (ICU) during 2014 and 2016 to 2018. Plasma samples were collected from ICU admission and every 4 h for 72 h or until death or ICU discharge and batch analysed for HBP. Mean arterial blood pressure (MAP) and noradrenaline dose (NA dose) were recorded at each sampling time point, and systemic vascular resistance index (SVRI) was recorded when available from non-invasive monitoring. The association between HBP, NA dose, MAP and SVRI was assessed respectively using mixed-effects linear regression models. Procalcitonin (PCT) was used as a comparator.

RESULTS: A total of 24 patients were included. The kinetics of plasma HBP was highly variable over time, with occasional >2-fold increases and decreases in between 4-h measurements. Every 100 ng/mL increase in HBP corresponded to a 30% increase in NA dose in a crude model (95% CI 3 to 60%, p = 0.03, nobs = 340), a 1.4-mmHg decrease in MAP in an adjusted model (95% CI - 1 to - 2.3 mmHg, p = 0.04) or a 99 dyne s cm-5 m-2 decrease in SVRI in another adjusted model (95% CI - 36 to - 162, p = 0.002, npat = 13). PCT had a stronger association to NA dose than HBP in a crude model but was not significantly associated to NA dose, MAP or SVRI in any time-adjusted model.

CONCLUSIONS: Plasma HBP displayed a highly variable kinetic pattern during septic shock and was significantly associated to cardiovascular organ dysfunction severity over time.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Intensive Care Medicine Experimental
volume
8
issue
1
article number
51
publisher
Springer
external identifiers
  • scopus:85099434516
  • pmid:32910266
ISSN
2197-425X
DOI
10.1186/s40635-020-00338-8
language
English
LU publication?
yes
id
6f9e096a-6254-46b0-adad-880e86e259c1
date added to LUP
2022-01-03 22:04:10
date last changed
2024-04-04 09:44:52
@article{6f9e096a-6254-46b0-adad-880e86e259c1,
  abstract     = {{<p>BACKGROUND: Heparin-binding protein (HBP) is a neutrophil-derived pro-inflammatory protein, an inducer of endothelial dysfunction and vascular permeability and a promising prognostic biomarker in sepsis. This exploratory study aims to describe the kinetics of plasma HBP during septic shock and investigate an association between repeated measures of HBP concentration and cardiovascular organ dysfunction severity.</p><p>METHODS: We included patients at or above 18 years with suspected septic shock on admission to the intensive care unit (ICU) during 2014 and 2016 to 2018. Plasma samples were collected from ICU admission and every 4 h for 72 h or until death or ICU discharge and batch analysed for HBP. Mean arterial blood pressure (MAP) and noradrenaline dose (NA dose) were recorded at each sampling time point, and systemic vascular resistance index (SVRI) was recorded when available from non-invasive monitoring. The association between HBP, NA dose, MAP and SVRI was assessed respectively using mixed-effects linear regression models. Procalcitonin (PCT) was used as a comparator.</p><p>RESULTS: A total of 24 patients were included. The kinetics of plasma HBP was highly variable over time, with occasional &gt;2-fold increases and decreases in between 4-h measurements. Every 100 ng/mL increase in HBP corresponded to a 30% increase in NA dose in a crude model (95% CI 3 to 60%, p = 0.03, nobs = 340), a 1.4-mmHg decrease in MAP in an adjusted model (95% CI - 1 to - 2.3 mmHg, p = 0.04) or a 99 dyne s cm-5 m-2 decrease in SVRI in another adjusted model (95% CI - 36 to - 162, p = 0.002, npat = 13). PCT had a stronger association to NA dose than HBP in a crude model but was not significantly associated to NA dose, MAP or SVRI in any time-adjusted model.</p><p>CONCLUSIONS: Plasma HBP displayed a highly variable kinetic pattern during septic shock and was significantly associated to cardiovascular organ dysfunction severity over time.</p>}},
  author       = {{Tverring, Jonas and Nielsen, Niklas and Dankiewicz, Josef and Linder, Adam and Kahn, Fredrik and Åkesson, Per}},
  issn         = {{2197-425X}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{1}},
  publisher    = {{Springer}},
  series       = {{Intensive Care Medicine Experimental}},
  title        = {{Repeated measures of Heparin-binding protein (HBP) and procalcitonin during septic shock : biomarker kinetics and association with cardiovascular organ dysfunction}},
  url          = {{http://dx.doi.org/10.1186/s40635-020-00338-8}},
  doi          = {{10.1186/s40635-020-00338-8}},
  volume       = {{8}},
  year         = {{2020}},
}