Mid-regional pro-adrenomedullin (MR-proADM), a marker of positive fluid balance in critically ill patients: results of the ENVOL study
| Autor: | Aurore Rodrigues, Frédérique Moati, Homa Rafi, Jacques Duranteau, Jean-Xavier Mazoit, Samy Figueiredo, Pierre-Etienne Leblanc, Hussam Foufa, Anatole Harrois, Eric Pussard, Bernard Vigué |
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| Jazyk: | angličtina |
| Předmět: |
Adult
Male medicine.medical_specialty Plasma biomarker Critical Illness MR-proADM Blood volume 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Sodium overload Norepinephrine (medication) Adrenomedullin Young Adult 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Atrial natriuretic peptide Internal medicine Renin–angiotensin system Extracellular fluid medicine Humans Intensive care unit Prospective Studies Aged Aged 80 and over Blood Volume Aldosterone Blood Volume Determination business.industry Research Extracellular Fluid 030208 emergency & critical care medicine Middle Aged Water-Electrolyte Balance Angiotensin II Fluid balance Surgery Red blood cell medicine.anatomical_structure chemistry Fluid overload Cardiology Female business Biomarkers medicine.drug |
| Zdroj: | Critical Care |
| ISSN: | 1364-8535 |
| DOI: | 10.1186/s13054-016-1540-x |
| Popis: | Background The optimal control of blood volume without fluid overload is a main challenge in the daily care of intensive care unit (ICU) patients. Accordingly this study focused on the identification of biomarkers to help characterize fluid overload status. Methods Sixty-seven patients were studied from ICU admission to day 7 (D7). Blood and urine samples were taken daily and sodium and water balance strictly calculated resulting in a total cumulative assessment of ∆Na+ and ∆H2O. Furthermore, plasmatic biomarkers (cortisol, epinephrine, norepinephrine, renin, angiotensin II, aldosterone, pro-endothelin, copeptine, atrial natriuretic peptide, erythropoietin, mid-regional pro-adrenomedullin (MR-proADM)) and Sequential Organ Failure Assessment (SOFA) scores were measured at D2, D5 and D7. Blood volumes were measured with 51Cr fixed on red blood cells at D2 and D7. Results The ∆Na+ or ∆H2O were increased in all patients but never related to blood volumes at D2 nor D7. Total blood volumes were at normal values with constantly low red blood cell volumes and normal or decreased plasmatic volume. Weight, plasmatic proteins, and hemoglobin were weakly related to ∆Na+ or ∆H2O. Amongst all tested biomarkers, only MR-proADM was related to sodium and fluid overload. This biomarker was also a predictor of SOFA scores. Conclusions Plasmatic concentration in MR-proADM seems to be a good surrogate for evaluation of ∆Na+ or ∆H2O and predicts sodium and extracellular fluid overload. Trial registration ClinicalTrials.gov: NCT01858675 in May 13, 2013. Electronic supplementary material The online version of this article (doi:10.1186/s13054-016-1540-x) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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