Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study.

Autor: Numan Y; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. numan@marshall.edu., Jawaid Y; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. Jawaidy@marshall.edu., Hirzallah H; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. Hirzallah@marshall.edu., Kusmic D; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. Kusmic@marshall.edu., Megri M; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. Megri@marshall.edu., Aqtash O; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. Aqtasho@marshall.edu., Amro A; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. Amro@marshall.edu., Mezughi H; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. Mezughi@marshall.edu., Maher E; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. Maher11@marshall.edu., Raru Y; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. Raru@marshall.edu., Numan J; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. numanj@marshall.edu., Akpanudo S; Internal Medicine Department, Marshall University, Huntington, WV 25755, USA. Akpanudo@marshall.edu., Khitan Z; Nephrology Department, Marshall University, Huntington, WV 25755, USA. zKhitan@marshall.edu., Shweihat Y; Pulmonary & Critical Care Department, Marshall University, Huntington, WV 25701, USA. Shweihat@marshall.edu.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2018 Jul 26; Vol. 7 (8). Date of Electronic Publication: 2018 Jul 26.
DOI: 10.3390/jcm7080182
Abstrakt: Objective: The use of serum ammonia as a novel marker for sepsis compared to lactic acid levels in intensive care unit (ICU) patients.
Design and Interventions: Single arm, prospective clinical trial to collect arterial blood samples from patients with sepsis. Serial ammonia and lactic acid levels were sent every six hours for a total of three days.
Measurements and Results: Compare mean levels of ammonia and lactic acid in terms of diagnosing sepsis and patient outcome, including length of stay and mortality. A total of 30 patients were enrolled in the pilot study. On admission, mean ammonia level was 35.7 μmol/L and lactic acid was 3.06 mmole/L. Ammonia levels checked at the end of day 2 (ammonia 2-4) and the beginning of day 3 (ammonia 3-1) were higher in patients who had a microbial culture-proven sepsis ( p -values 0.029 and 0.002, respectively) compared to those without culture-positive sepsis. Ammonia levels did predict a longer hospital stay; ammonia level of more than 40 μmol/L had a mean hospital stay of 17.6 days vs. patients with normal levels who had a mean hospital stay of 9.62 days ( p -value 0.0082).
Conclusion: Elevated ammonia level can be a novel biomarker for sepsis, comparable to conventional markers. Ammonia levels have a prognostic utility as elevated levels were associated with longer hospital stay.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje