Pentraxin-3, Troponin T, N-Terminal Pro-B-Type Natriuretic Peptide in Septic Patients

Progress in the Clinical Assessment and Treatment of Myocardial Depression in Critically Ill Patient with Sepsis

Myocardial inhibition is the main cause of death in patients with sepsis.In recent years, methodological differences in the diagnosis, assessment, and treatment of septic myocardial depression have been observed, and how to objectively and accurately evaluate the degree of myocardial depression and the timing of treatment strategies have generally been the focus of this area of research. Based on the relevant research at home and abroad, the current review summarizes the clinical characteristics, methodological diagnosis, and symptomatic treatment of septic myocardial depression. The aim of doing so is to provide a reference for the early identification and treatment of patients with sepsis and myocardial depression.

Correlation and Prognostic Action of SAA, Hcy, and BNP Levels with the Condition of Patients with Spontaneous Intracerebral Hemorrhage

Objective

To explore the correlation of serum amyloid A (SAA), homocysteine (Hcy), and plasma B-type brain natriuretic peptide (BNP) levels in patients with spontaneous intracerebral hemorrhage (SICH) and their predictive value for the status and prognosis of SICH patients.

Methods

82 SICH patients admitted to our hospital from March 2017 to March 2020 were selected. According to the Glasgow coma scale (GCS) score, the patients were divided into GCS > 8 group (n = 44) and the GCS ≤ 8 group (n = 38). Based on the bleeding volume, the patients were divided into the massive bleeding group (>30 ml) (n = 21), the moderate bleeding group (10∼30 ml) (n = 28), and the small bleeding group (<10 ml) (n = 33). Based on the prognostic status of patients after 28 days of admission, they were divided into the survival group (n = 64) and the death group (n = 18). Serum SAA, Hcy, and plasma BNP levels of patients in different groups were compared, and the correlation between serum SAA, Hcy and plasma BNP levels with GCS score, cerebral hemorrhage, and the prognostic value of patients was analyzed.

Results

Serum SAA, Hcy, and plasma BNP levels in patients with GCS ≤ 8 groups were higher than those in GCS > 8 groups (P < 0.05). Serum SAA, Hcy, and plasma BNP levels of patients in the massive bleeding group were higher than those in the moderate and small bleeding groups. Besides, the level of serum SAA, Hcy, and plasma BNP in the moderate bleeding group was higher than that in the small bleeding group (P < 0.05). Serum SAA, Hcy and plasma BNP levels of patients were negatively correlated with GCS scores but positively correlated with bleeding volume (P < 0.05). The levels of serum SAA, Hcy and plasma BNP in dead patients were higher than those in the survival patients (P < 0.05). The combined prediction of serum SAA, Hcy, and plasma BNP for the prognosis of SICH patients was 0.910 (95% CI: 0.984∼0.837), which was higher than the serum SAA, Hcy, and plasma BNP alone predicted AUC 0.679 (95% CI: 0.564∼0.795), 0.720 (95% CI: 0.603∼0.836), and 0.726 (95% CI: 0.616∼0.849).

Conclusion

The levels of serum SAA, Hcy, and plasma BNP have a correlation with the severity and prognosis of patients with SICH, which is a feasible index for judging the prognosis of SICH. The levels of serum SAA, Hcy, and plasma BNP are conducive to timely judgment of the progression and prognosis of SICH patients.

Pentraxin-3 as a predictive marker of mortality in sepsis: an updated systematic review and meta-analysis

BACKGROUND

The purpose of this study was to clarify the prognostic value of Pentraxin-3 (PTX3) on the mortality of patients with sepsis.

METHODS

Publications published up to January 2021 were retrieved from PubMed, EMBASE, and the Cochrane library. Data from eligible cohort and case-control studies were extracted for the meta-analysis. Multivariate regression analysis was used to evaluate the correlation of the outcomes with sample size and male proportion.

RESULTS

A total of 17 studies covering 3658 sepsis patients were included. PTX3 level was significantly higher in non-survivor compared to survivor patients (SMD (95% CI): -1.06 (-1.43, -0.69), P < 0.001). Increased PTX3 level was significantly associated with mortality (HR (95% CI): 2.09 (1.55, 2.81), P < 0.001). PTX3 showed good predictive capability for mortality (AUC:ES (95% CI): 0.73 (0.70, 0.77), P < 0.001). The outcome comparing PTX3 level in non-survivors vs. survivors and the outcome of the association between PTX3 and mortality were associated with sample size but not male proportion. AUC was associated with both sample size and male proportion.

CONCLUSIONS

PTX3 level was significantly higher in non-survivor compared to survivor patients with sepsis. Elevated PTX3 level was significantly associated with mortality. Furthermore, the level of PTX3 might predict patient mortality.

Pentraxin-3 Is a Strong Biomarker of Sepsis Severity Identification and Predictor of 90-Day Mortality in Intensive Care Units via Sepsis 3.0 Definitions

BACKGROUND

Sepsis is the leading cause of mortality in intensive care units (ICUs). However, early diagnosis and prognosis of sepsis and septic shock are still a great challenge. Pentraxin-3 (PTX3) was shown to be associated with the severity and outcome of sepsis and septic shock. This study was carried out to investigate the diagnostic and prognostic value of PTX3 in patients with sepsis and septic shock based on Sepsis 3.0 definitions.

METHODS

In this single-center prospective observational study, all patients' serum was collected for biomarker measurements within 24 h after admission. Logistic and Cox regression analyses were used to identify the potential biomarkers of diagnosis, severity stratification, and prediction.

RESULTS

Serum levels of PTX3 were significantly increased on the first day of ICU admission, while septic shock patients had highest PTX3 levels than other groups. A combination between PTX3 and procalcitonin (PCT) could better discriminate sepsis and septic shock, and PTX3 was an independent predictor of mortality in sepsis and septic shock patients.

CONCLUSION

PTX3 may be a robust biomarker to classify the disease severity and predict the 90-day mortality of sepsis and septic shock based on the latest Sepsis 3.0 definitions.