Circulating adrenomedullin estimates survival and reversibility of organ failure in sepsis: the prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock-1 (AdrenOSS-1) study

Massimo Antonelli, Alexandre Mebazaa, Christopher Geven, Alexa Hollinger, Xavier Wittebole, Benjamin Glen Chousterman, Alice Blet, Etienne Gayat, Oliver Hartmann, Paul Scigalla, Joachim Struck, Andreas Bergmann, Albertus Beishuizen, Jean-Michel Constantin, Charles Damoisel, Nicolas Deye, Salvatore Di Somma, Thierry Dugernier, Bruno François, Stephane GaudryVincent Huberlant, Jean-Baptiste Lascarrou, Gernot Marx, Emmanuelle Mercier, Haikel Oueslati, Peter Pickkers, Romain Sonneville, Matthieu Legrand, Pierre-François Laterre, Pierre François Laterre, Caroline Berghe, Marie-France Dujardin, Suzanne Renard, Christine Collienne, Diego Castanares Zapatero, Marco Vinetti, Nicolas De Schryver, Anne Thirifays, Jacques Mairesse, Hélène Petre, Isabelle Buelens, Pierre Henin, Hugues Trine, Yves Laurent, Loix Sébastien, Paul Geukens, Laurent Kehl, Philippe Vignon, Nicolas Pichon, Emmanuelle Begot, Anne-Laure Fedou, Catherine Chapellas, Antoine Galy, Nicolas Rodier, Ludmilla Baudrillart, Michelle Nouaille, Séverine Laleu, Claire Mancia, Thomas Daix, Paul Bourzeix, Isabelle Herafa, Anne-Aurore Duchambon, Jean Baptiste Lascarrou, Maud Fiancette, Gwenhael Colin, Matthieu Henry-Lagarrigue, Jean-Claude Lacherade, Christine Lebert, Laurent Martin-Levèvre, Isabelle Vinatier, Aihem Yehia, Konstantinos Bachoumas, Aurélie Joret, Jean Reignier, Cécille Rousseau, Natacha Maquigneau, Yolaine Alcourt, Vanessa Erragne Zinzonni, Angélique Deschamps, Angelina Robert, Véronique Simeon-Vieules, Aurélie Aubrey, Christine Mabilat, Denis Garot, Stephan Ehrmann, Annick Legras, Youenn Jouan, Pierre François Dequin, Antoine Guillon, Laetitia Bodet-Contentin, Emmannuelle Rouve, Charlotte Salmon, Lysiane Brick, Stéphanie Massat, Arnaud Desachy, Marie Anne Fally, Laurence Robin, Christophe Cracco, Charles Lafon, Sylvie Calvat, Stéphane Rouleau, David Schnell, Sigismond Lasocki, Philippe Fesard, Damien Leblanc, Guillaume Bouhours, Claire Chassier, Mathieu Conte, Thomas Gaillard, Floriane Denou, Mathieu Kerymel, Marion Guyon, Anthéa Loiez, Stéphanie Lebreton, Ferhat Meziani, Hayat Allam, Samir Chenaf, Hassène Rahmani, Sarah Heenen, Christine Kummerlen, Xavier Delabranche, Alexandra Boivin, Raphaël Clere-Jehl, Yannick Rabouël, Julien Pottecher, Sophie Bayer, Catherine Metzger, Stéphane Hecketsweiler, Pierre Olivier Ludes, Hortense Besancenot, Nadia Dhif, Guy Freys, Jean-Marc Lessinger, Anne Launoy, Aude Ruimy, Alain Meyer, M. Szozot, Marie-Céline Fournier, Sarra Abroug, Badr Louadah, Elodie Feliot, Sebastian Voicu, I. Malissin, Bruno Megarbane, Philippe Manivet, Gardianot Victori, Da Silva Kelly, Béatrice La Foucher, Valérie Pierre, Lamia Kerdjana, Thomas Beeken, Antoine Goury, Pierre Garcon, Samuel Gaugain, Benjamin Huot, Romain Barthelemy, Benjamin Soyer, Laurent Jacob, Francine Bonnet, Chloé Legall, Alexandru Cupaciu, Sophie Letrou, Lila Bouadma, Bruno Mourvillier, Véronique Deiler, Eric Magalhaes, Mathilde Neuville, Jean-François Timsit, Aguila Radjou, Emeline Dubief, Jonathan Messika, Béatrice La Combe, Damien Roux, Guillaume Berquier, Mohamed Laissi, Jean-Damien Ricard, Sebastien Perbet, Julie Delmas, Julien Pascal, Sophie Cayot, Renaud Guerin, Matthieu Jabaudon, Laurence Roszyk, Christine Rolhion, Justine Bourdier, Mathilde Lematte, Charlène Gouhier, Camille Verlhac, Thomas Godet, Sophiano Radji, Elodie Caumon, Sandrine Thibault, Nikolaus Marx, Tobias Schuerholz, Jessica Pezechk, Florian Feld, Christian Brülls, Thorben Beeker, Tim-Philipp Simon, Robert Deisz, Achim Schindler, Bianca Meier, Thorsten Janisch, Andreas Hohn, Dirk Schedler, Wolfgang Wetsch, Daniel Schröder, Andreas Meier-Hellmann, Alexander Lucht, Robert Henker, Magdalena Römmer, Torsten Meinig, Kai D. Zacharowski, Patrick Meybohm, Simone Lindau, Haitham Mutlak, Stefan Kluge, Grit Ringeis, Birgit Füllekrug, Brigitte Singer, Axel Nierhaus, Katrin Bangert, Geraldine De Heer, Daniel Frings, Valentin Fuhrmann, Jakob Müller, Jörg Schreiber, Barbara Sensen, Stephanie Siedler, Annekatrin Siewecke, Gerold Söffker, Dominic Wichmann, Mélanie Kerinn, Ulrich Jaschinski, Ilse Kreuser, Marlene Zanquila, Andreas Kortgen, Frank Bloos, Falk Gonnert, Daniel Thomas-Rüddel, Anja Haucke, Steffi Kolanos, Karina Knuhr Kohlberg, Petra Bloos, Katrin Schwope, Veronica Russo, Santarelli Simona, Christopher Bartoli, Sylvia Navarin, Cristina Bongiovanni, Michela Orru, Daniela Quatrocchi, Giada Zoccoli, Antonella Varchetta, Maria Sole Vallecoccia, Salvatore Lucio Cutuli, Valentina Digravio, Daniela Quattrochi, Sonia D'Arrigo, Filippo Elvino Leone, Bert Beishuizen, Martin Rinket, Natalie Border, Mariska Bos-Burgmeijer, Astrid Braad, S. Papendorp, Alexander Cornet, J. Vermeijden, Ronald J. Trof, Helen Van Wezel, Leo Heunks, Astrid Hoedemaekers, Hans Van Der Hoeven, Noortje Roovers, Pleun Hemelaar

Risultato della ricerca: Contributo in rivistaArticolo in rivista

18 Citazioni (Scopus)

Abstract

BACKGROUND: Adrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, we assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled trial. METHODS: AdrenOSS-1 was a prospective observational multinational study. The primary outcome was 28-day mortality. Secondary outcomes included organ failure as defined by Sequential Organ Failure Assessment (SOFA) score, organ support with focus on vasopressor/inotropic use, and need for renal replacement therapy. AdrenOSS-1 included 583 patients admitted to the ICU with sepsis or septic shock. RESULTS: Circulating bio-ADM levels were measured upon admission and at day 2. Median bio-ADM concentration upon admission was 80.5 pg/ml [IQR 41.5-148.1 pg/ml]. Initial SOFA score was 7 [IQR 5-10], and 28-day mortality was 22%. We found marked associations between bio-ADM upon admission and 28-day mortality (unadjusted standardized HR 2.3 [CI 1.9-2.9]; adjusted HR 1.6 [CI 1.1-2.5]) and between bio-ADM levels and SOFA score (p < 0.0001). Need of vasopressor/inotrope, renal replacement therapy, and positive fluid balance were more prevalent in patients with a bio-ADM > 70 pg/ml upon admission than in those with bio-ADM ≤ 70 pg/ml. In patients with bio-ADM > 70 pg/ml upon admission, decrease in bio-ADM below 70 pg/ml at day 2 was associated with recovery of organ function at day 7 and better 28-day outcome (9.5% mortality). By contrast, persistently elevated bio-ADM at day 2 was associated with prolonged organ dysfunction and high 28-day mortality (38.1% mortality, HR 4.9, 95% CI 2.5-9.8). CONCLUSIONS: AdrenOSS-1 shows that early levels and rapid changes in bio-ADM estimate short-term outcome in sepsis and septic shock. These data are the backbone of the design of the biomarker-guided AdrenOSS-2 trial.
Lingua originaleEnglish
pagine (da-a)1-1
Numero di pagine1
RivistaCritical Care
Stato di pubblicazionePubblicato - 2019

Keywords

  • Biomarker
  • Outcome
  • Sepsis-2
  • Sepsis-3

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