1. Added value of serial bio-adrenomedullin measurement in addition to lactate for the prognosis of septic patients admitted to ICU
- Author
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Blet, Alice, De Roquetaillade, Charles, Hartmann, Oliver, Struck, Joachim, Mebazaa, Alexandre, Chousterman, Benjamin Glenn, Laterre, Pierre François, Berghe, Caroline, Dujardin, Marie France, Renard, Suzanne, Wittebole, Xavier, Collienne, Christine, Zapatero, Diego Castanares, Dugernier, Thierry, Vinetti, Marco, De Schryver, Nicolas, Thirifays, Anne, Mairesse, Jacques, Huberlant, Vincent, Petre, Hélène, Buelens, Isabelle, Henin, Pierre, Trine, Hugues, Laurent, Yves, Sébastien, Loix, Geukens, Paul, Kehl, Laurent, François, Bruno, Vignon, Philippe, Pichon, Nicolas, Begot, Emmanuelle, Fedou, Anne Laure, Chapellas, Catherine, Galy, Antoine, Rodier, Nicolas, Baudrillart, Ludmilla, Nouaille, Michelle, Laleu, Séverine, Mancia, Claire, Daix, Thomas, Bourzeix, Paul, Herafa, Isabelle, Duchambon, Anne Aurore, Lascarrou, Jean Baptiste, Fiancette, Maud, Colin, Gwenhael, Henry-Lagarrigue, Matthieu, Lacherade, Jean Claude, Lebert, Christine, Martin-Levfèvre, Laurent, Vinatier, Isabelle, Yehia, Aihem, Bachoumas, Konstantinos, Joret, Aurélie, Reignier, Jean, Rousseau, Cécille, Maquigneau, Natacha, Alcourt, Yolaine, Zinzonni, Vanessa Erragne, Deschamps, Angélique, Robert, Angelina, Mercier, Emmanuelle, Simeon-Vieules, Véronique, Aubrey, Aurélie, Mabilat, Christine, Garot, Denis, Ehrmann, Stephan, Legras, Annick, Jouan, Youenn, Dequin, Pierre François, Guillon, Antoine, Bodet-Contentin, Laetitia, Rouve, Emmannuelle, Salmon, Charlotte, Brick, Lysiane, Massat, Stéphanie, Desachy, Arnaud, Fally, Marie Anne, Robin, Laurence, Cracco, Christophe, Lafon, Charles, Calvat, Sylvie, Rouleau, Stéphane, Schnell, David, Lasocki, Sigismond, Fesard, Philippe, Leblanc, Damien, Bouhours, Guillaume, Chassier, Claire, Conte, Mathieu, Gaillard, Thomas, Denou, Floriane, Kerymel, Mathieu, Guyon, Marion, Loiez, Anthéa, Lebreton, Stéphanie, Meziani, Ferhat, Allam, Hayat, Chenaf, Samir, Rahmani, Hassène, Heenen, Sarah, Kummerlen, Christine, Delabranche, Xavier, Boivin, Alexandra, Clere-Jehl, Raphaël, Rabouël, Yannick, Pottecher, Julien, Bayer, Sophie, Metzger, Catherine, Hecketsweiler, Stéphane, Ludes, Pierre Olivier, Besancenot, Hortense, Dhif, Nadia, Freys, Guy, Lessinger, Jean Marc, Launoy, Anne, Ruimy, Aude, Meyer, Alain, Szozot, M., Deye, Nicolas, Gayat, Etienne, Fournier, Marie Céline, Abroug, Sarra, Louadah, Badr, Feliot, Elodie, Voicu, Sebastian, Malissin, Isabelle, Megarbane, Bruno, Manivet, Philippe, Victori, Gardianot, Kelly, Da Silva, La Foucher, Béatrice, Pierre, Valérie, Kerdjana, Lamia, Beeken, Thomas, Goury, Antoine, Garcon, Pierre, Gaugain, Samuel, Huot, Benjamin, Barthelemy, Romain, Soyer, Benjamin, Jacob, Laurent, Legrand, Matthieu, Fourniar, Marie Céline, Bonnet, Francine, Legall, Chloé, Oueslati, Haikel, Cupaciu, Alexandru, Manivat, Philippe, Louadeh, Badr, Sonneville, Romain, Letrou, Sophie, Bouadma, Lila, Mourvillier, Bruno, Deiler, Véronique, Magalhaes, Eric, Neuville, Mathilde, Timsit, Jean François, Radjou, Aguila, Gaudry, Stéphane, Dubief, Emeline, Messika, Jonathan, La Combe, Béatrice, Roux, Damien, Berquier, Guillaume, Laissi, Mohamed, Ricard, Jean Damien, Constantin, Jean Michel, Perbet, Sebastien, Delmas, Julie, Pascal, Julien, Cayot, Sophie, Guerin, Renaud, Jabaudon, Matthieu, Roszyk, Laurence, Rolhion, Christine, Bourdier, Justine, Lematte, Mathilde, Gouhier, Charlène, Verlhac, Camille, Godet, Thomas, Radji, Sophiano, Caumon, Elodie, Thibault, Sandrine, Marx, Nikolaus, Schuerholz, Tobias, Pezechk, Jessica, Feld, Florian, Brülls, Christian, Beeker, Thorben, Simon, Tim Philipp, Deisz, Robert, Schindler, Achim, Meier, Bianca, Janisch, Thorsten, Hohn, Andreas, Schedler, Dirk, Wetsch, Wolfgang, Schröder, Daniel, Meier-Hellmann, Andreas, Lucht, Alexander, Henker, Robert, Römmer, Magdalena, Meinig, Torsten, Zacharowski, Kai D., Meybohm, Patrick, Lindau, Simone, Mutlak, Haitham, Kluge, Stefan, Ringeis, Grit, Füllekrug, Birgit, Singer, Brigitte, Nierhaus, Axel, Bangert, Katrin, De Heer, Geraldine, Frings, Daniel, Fuhrmann, Valentin, Müller, Jakob, Schreiber, Jörg, Sensen, Barbara, Siedler, Stephanie, Siewecke, Annekatrin, Söffker, Gerold, Wichmann, Dominic, Kerinn, Mélanie, Jaschinski, Ulrich, Kreuser, Ilse, Zanquila, Marlene, Kortgen, Andreas, Bloos, Frank, Gonnert, Falk, Thomas-Rüddel, Daniel, Haucke, Anja, Kolanos, Steffi, Kohlberg, Karina Knuhr, Bloos, Petra, Schwope, Katrin, Di Somma, Salvatore, Rossella, Marino, Russo, Veronica, Simona, Santarelli, Bartoli, Christopher, Navarin, Sylvia, Bongiovanni, Cristina, Orru, Michela, Quatrocchi, Daniela, Zoccoli, Giada, Varchetta, Antonella, Antonelli, Massimo, De Pascale, Gennaro, Vallecoccia, Maria Sole, Cutuli, Salvatore Lucio, Digravio, Valentina, Quattrochi, Daniela, D'Arrigo, Sonia, Leone, Filippo Elvino, Beishuizen, Bert, Rinket, Martin, Border, Natalie, Bos-Burgmeijer, Mariska, Braad, Astrid, Papendorp, S., Vermeijden, J., Pickkers, Peter, Van De A, Marieke, Van Wezel, Helen, Heunks, Leo, Bordar, Natalie, Luijten-Arts, Chantal, Hoedemaekers, Astrid, Van Der Hoeven, Hans, Roovers, Noortje, Hemelaar, Pleun, Intensive care medicine, ACS - Pulmonary hypertension & thrombosis, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, and UCL - (SLuc) Service de soins intensifs
- Subjects
Male ,medicine.medical_specialty ,Multiple Organ Failure ,MEDLINE ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,Critical Care and Intensive Care Medicine ,Sepsis ,03 medical and health sciences ,Adrenomedullin ,0302 clinical medicine ,Belgium ,Germany ,medicine ,Research Letter ,Humans ,Lactic Acid ,Hospital Mortality ,Prospective Studies ,Prospective cohort study ,Aged ,Netherlands ,Proportional Hazards Models ,Chi-Square Distribution ,business.industry ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,030208 emergency & critical care medicine ,lcsh:RC86-88.9 ,Length of Stay ,Middle Aged ,medicine.disease ,Prognosis ,Shock, Septic ,Survival Analysis ,3. Good health ,Hospitalization ,Patient Outcome Assessment ,Intensive Care Units ,030228 respiratory system ,Italy ,Shock (circulatory) ,Emergency medicine ,Female ,France ,medicine.symptom ,business ,Biomarkers - Abstract
Adrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, we assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled trial.AdrenOSS-1 was a prospective observational multinational study. The primary outcome was 28-day mortality. Secondary outcomes included organ failure as defined by Sequential Organ Failure Assessment (SOFA) score, organ support with focus on vasopressor/inotropic use, and need for renal replacement therapy. AdrenOSS-1 included 583 patients admitted to the ICU with sepsis or septic shock.Circulating bio-ADM levels were measured upon admission and at day 2. Median bio-ADM concentration upon admission was 80.5 pg/ml [IQR 41.5-148.1 pg/ml]. Initial SOFA score was 7 [IQR 5-10], and 28-day mortality was 22%. We found marked associations between bio-ADM upon admission and 28-day mortality (unadjusted standardized HR 2.3 [CI 1.9-2.9]; adjusted HR 1.6 [CI 1.1-2.5]) and between bio-ADM levels and SOFA score (p0.0001). Need of vasopressor/inotrope, renal replacement therapy, and positive fluid balance were more prevalent in patients with a bio-ADM70 pg/ml upon admission than in those with bio-ADM ≤ 70 pg/ml. In patients with bio-ADM70 pg/ml upon admission, decrease in bio-ADM below 70 pg/ml at day 2 was associated with recovery of organ function at day 7 and better 28-day outcome (9.5% mortality). By contrast, persistently elevated bio-ADM at day 2 was associated with prolonged organ dysfunction and high 28-day mortality (38.1% mortality, HR 4.9, 95% CI 2.5-9.8).AdrenOSS-1 shows that early levels and rapid changes in bio-ADM estimate short-term outcome in sepsis and septic shock. These data are the backbone of the design of the biomarker-guided AdrenOSS-2 trial.ClinicalTrials.gov, NCT02393781 . Registered on March 19, 2015.
- Published
- 2020
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