Early prognostic factors in septic shock ...
Type de document :
Compte-rendu et recension critique d'ouvrage
DOI :
Titre :
Early prognostic factors in septic shock cancer patients: a prospective study with a proteomic approach
Auteur(s) :
Mokart, D. [Auteur]
Saillard, C. [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Zemmour, C. [Auteur]
Bisbal, M. [Auteur]
Sannini, A. [Auteur]
Chow-Chine, L. [Auteur]
Brun, J. -P. [Auteur]
Faucher, Marc [Auteur]
Institut d’Électronique, de Microélectronique et de Nanotechnologie - UMR 8520 [IEMN]
Nano and Microsystems - IEMN [NAM6 - IEMN]
Boher, J. -M. [Auteur]
Toiron, Y. [Auteur]
Chabannon, C. [Auteur]
Borg, J. -P. [Auteur]
Goncalves, A. [Auteur]
Centre de Recherche en Cancérologie de Marseille [CRCM]
Camoin, L. [Auteur]
Microbes évolution phylogénie et infections [MEPHI]
Saillard, C. [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Zemmour, C. [Auteur]
Bisbal, M. [Auteur]
Sannini, A. [Auteur]
Chow-Chine, L. [Auteur]
Brun, J. -P. [Auteur]
Faucher, Marc [Auteur]
Institut d’Électronique, de Microélectronique et de Nanotechnologie - UMR 8520 [IEMN]
Nano and Microsystems - IEMN [NAM6 - IEMN]
Boher, J. -M. [Auteur]
Toiron, Y. [Auteur]
Chabannon, C. [Auteur]
Borg, J. -P. [Auteur]
Goncalves, A. [Auteur]
Centre de Recherche en Cancérologie de Marseille [CRCM]
Camoin, L. [Auteur]
Microbes évolution phylogénie et infections [MEPHI]
Titre de la revue :
Acta Anaesthesiologica Scandinavica
Pagination :
493-503
Éditeur :
Wiley
Date de publication :
2018
ISSN :
0001-5172
Discipline(s) HAL :
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Maladies infectieuses
Résumé en anglais : [en]
BackgroundOrgan failures are the main prognostic factors in septic shock. The aim was to assess classical clinico-biological parameters evaluating organ dysfunctions at intensive care unit admission, combined with proteomics, ...
Lire la suite >BackgroundOrgan failures are the main prognostic factors in septic shock. The aim was to assess classical clinico-biological parameters evaluating organ dysfunctions at intensive care unit admission, combined with proteomics, on day-30 mortality in critically ill onco-hematology patients admitted to the intensive care unit for septic shock. MethodsThis was a prospective monocenter cohort study. Clinico-biological parameters were collected at admission. Plasma proteomics analyses were performed, including protein profiling using isobaric Tag for Relative and Absolute Quantification (iTRAQ) and subsequent validation by ELISA. ResultsSixty consecutive patients were included. Day-30 mortality was 47%. All required vasopressors, 32% mechanical ventilation, 33% non-invasive ventilation and 13% renal-replacement therapy. iTRAQ-based proteomics identified von Willebrand factor as a protein of interest. Multivariate analysis identified four factors independently associated with day-30 mortality: positive fluid balance in the first 24 h (odds ratio = 1.06, 95% CI = 1.01-1.12, P = 0.02), severe acute respiratory failure (odds ratio = 6.14(,) 95% CI = 1.04-36.15, P = 0.04), von Willebrand factor plasma level > 439 ng/ml (odds ratio = 9.7, 95% CI = 1.52-61.98, P = 0.02), and bacteremia (odds ratio = 6.98, 95% CI = 1.17-41.6, P = 0.03). ConclusionEndothelial dysfunction, revealed by proteomics, appears as an independent prognostic factor on day-30 mortality, as well as hydric balance, acute respiratory failure and bacteremia, in critically ill cancer patients admitted to the intensive care unit. Endothelial failure is underestimated in clinical practice and represents an innovative therapeutic target.Lire moins >
Lire la suite >BackgroundOrgan failures are the main prognostic factors in septic shock. The aim was to assess classical clinico-biological parameters evaluating organ dysfunctions at intensive care unit admission, combined with proteomics, on day-30 mortality in critically ill onco-hematology patients admitted to the intensive care unit for septic shock. MethodsThis was a prospective monocenter cohort study. Clinico-biological parameters were collected at admission. Plasma proteomics analyses were performed, including protein profiling using isobaric Tag for Relative and Absolute Quantification (iTRAQ) and subsequent validation by ELISA. ResultsSixty consecutive patients were included. Day-30 mortality was 47%. All required vasopressors, 32% mechanical ventilation, 33% non-invasive ventilation and 13% renal-replacement therapy. iTRAQ-based proteomics identified von Willebrand factor as a protein of interest. Multivariate analysis identified four factors independently associated with day-30 mortality: positive fluid balance in the first 24 h (odds ratio = 1.06, 95% CI = 1.01-1.12, P = 0.02), severe acute respiratory failure (odds ratio = 6.14(,) 95% CI = 1.04-36.15, P = 0.04), von Willebrand factor plasma level > 439 ng/ml (odds ratio = 9.7, 95% CI = 1.52-61.98, P = 0.02), and bacteremia (odds ratio = 6.98, 95% CI = 1.17-41.6, P = 0.03). ConclusionEndothelial dysfunction, revealed by proteomics, appears as an independent prognostic factor on day-30 mortality, as well as hydric balance, acute respiratory failure and bacteremia, in critically ill cancer patients admitted to the intensive care unit. Endothelial failure is underestimated in clinical practice and represents an innovative therapeutic target.Lire moins >
Langue :
Anglais
Vulgarisation :
Non
Source :