• Users Online: 284
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2016  |  Volume : 44  |  Issue : 3  |  Page : 107-118

Role of heparin-binding protein and brachial artery reactivity as prognostic tests in critically ill patients with sepsis


1 Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
2 Critical Care Unit Shebin Elkom Teaching Hospital, Shebin Elkom Hospital, Menoufia, Egypt

Correspondence Address:
Talal I.M Hagag
Shebin Elkom Hospital, Menoufia
Egypt
Login to access the Email id


DOI: 10.4103/1110-1415.198657

Rights and Permissions

Context Early detection of severe sepsis is crucial for successful outcome. We hypothesized that the progression of sepsis to severe sepsis is preceded by vascular leakage, which may be caused by neutrophil-derived mediators such as heparin-binding protein (HBP). Also, vascular leakage can be assessed by flow-mediated dilatation (FMD) and reactive hyperemia. Thus, both HBP and brachial artery reactivity may predict the progression of sepsis to severe sepsis and septic shock. Aim The aim of the study was to identify the role of both HBP and brachial artery reactivity as predictors of morbidity and mortality in critically ill septic patients. Settings and design This is an observational prospective controlled study. Patients and methods Patients were classified into two groups. Group I included 40 patients with evident sepsis. Group II included 10 critically ill nonseptic patients who constituted the control group. HBP blood samples were collected at three time points over 6 days after admission. Brachial artery reactivity measurements were also taken. Statistical analysis Statistical analysis was carried out on a personal computer using IBM SPSS Statistics (version 22). Results Significant difference was detected between survivors and nonsurvivors in maximum sequential organ failure assessment (SOFA) score, white blood cells, HBP at baseline and that at 48 and 96 h. The receiver operating characteristic curve using baseline HBP for prediction of severe sepsis shows a sensitivity of 94.7% and a specificity of 100% at cutoff level more than 1.9 ng/ml, and that for prediction of mortality shows a sensitivity of 91.6% and specificity of 100% at levels more than 1.9 ng/ml. Highly significant difference exists between survivors and nonsurvivors in FMD, baseline velocity, hyperemic velocity, velocity difference, and postdeflation resistance index (RI). Receiver operating characteristic curve analysis for prediction of severe sepsis/septic shock using FMD showed a sensitivity of 94.7%, specificity of 100% and associated criterion 3.4% or less. Hyperemic velocity had a sensitivity of 100%, specificity of 100%, and associated criterion 39 cm/cardiac cycle or less. Conclusion Plasma HBP levels and brachial artery reactivity can predict severe sepsis and mortality in patients with sepsis.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1196    
    Printed52    
    Emailed0    
    PDF Downloaded85    
    Comments [Add]    

Recommend this journal