Mid-Regional Proadrenomedullin (MR-proADM) and Microcirculation in Monitoring Organ Dysfunction of Critical Care Patients With Infection: A Prospective Observational Pilot Study
Introduction: Microvascular alterations are involved in the development of organ injury in critical care patients. Mid-regional proadrenomedullin (MR-proADM) may predict organ damage and its evolution. The main objective of this study was to assess the correlation between MR-proADM and microvascular...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:1251d9bc398f41e3b9ba7febdcebce0a2021-12-01T16:33:28ZMid-Regional Proadrenomedullin (MR-proADM) and Microcirculation in Monitoring Organ Dysfunction of Critical Care Patients With Infection: A Prospective Observational Pilot Study2296-858X10.3389/fmed.2021.680244https://doaj.org/article/1251d9bc398f41e3b9ba7febdcebce0a2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.680244/fullhttps://doaj.org/toc/2296-858XIntroduction: Microvascular alterations are involved in the development of organ injury in critical care patients. Mid-regional proadrenomedullin (MR-proADM) may predict organ damage and its evolution. The main objective of this study was to assess the correlation between MR-proADM and microvascular flow index (MFI) in a small cohort of 20 adult critical care patients diagnosed with infection, sepsis, or septic shock. Further objectives were to evaluate the correlation between the clearance of MR-proADM and the variables of microcirculation and between MR-proADM and the Sequential Organ Failure Assessment (SOFA) score.Materials and Methods: This is a prospective observational pilot study. Inclusion criteria: consecutive adult patients admitted to intensive care unit (ICU) for or with infection-related illness. Daily measurement of MR-proADM and calculation of the SOFA score from admission in ICU to day 5. Repeated evaluations of sublingual microcirculation, collection of clinical data, and laboratory tests.Results: Primary outcome: MR-proADM was not significantly correlated to the MFI at admission in ICU. A clearance of MR-proADM of 20% or more in the first 24 h was related to the improvement of the MFIs and MFIt [percentual variation of the MFIs + 12.35 (6.01–14.59)% vs. +2.23 (−4.45–6.01)%, p = 0.005; MFIt +9.09 (4.53–16.26)% vs. −1.43 (−4.36–3.12)%, p = 0.002].Conclusion: This study did not support a direct correlation of MR-proADM with the MFI at admission in ICU; however, it showed a good correlation between the clearance of MR-proADM, MFI, and other microvascular variables. This study also supported the prognostic value of the marker. Adequately powered studies should be performed to confirm the findings.Roberta DomiziElisa DamianiElisa DamianiClaudia ScorcellaAndrea CarsettiAndrea CarsettiPaolo GiaccagliaPaolo GiaccagliaErika CasarottaErika CasarottaJonathan MontomoliJonathan MontomoliVincenzo GabbanelliMarina BrugiaMarco MorettiErica AdrarioErica AdrarioAbele DonatiAbele DonatiFrontiers Media S.A.articlemid-regional proadrenomedullinmicrocirculationsepsisseptic shockinfectionorgan failureMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021) |
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mid-regional proadrenomedullin microcirculation sepsis septic shock infection organ failure Medicine (General) R5-920 |
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mid-regional proadrenomedullin microcirculation sepsis septic shock infection organ failure Medicine (General) R5-920 Roberta Domizi Elisa Damiani Elisa Damiani Claudia Scorcella Andrea Carsetti Andrea Carsetti Paolo Giaccaglia Paolo Giaccaglia Erika Casarotta Erika Casarotta Jonathan Montomoli Jonathan Montomoli Vincenzo Gabbanelli Marina Brugia Marco Moretti Erica Adrario Erica Adrario Abele Donati Abele Donati Mid-Regional Proadrenomedullin (MR-proADM) and Microcirculation in Monitoring Organ Dysfunction of Critical Care Patients With Infection: A Prospective Observational Pilot Study |
| description |
Introduction: Microvascular alterations are involved in the development of organ injury in critical care patients. Mid-regional proadrenomedullin (MR-proADM) may predict organ damage and its evolution. The main objective of this study was to assess the correlation between MR-proADM and microvascular flow index (MFI) in a small cohort of 20 adult critical care patients diagnosed with infection, sepsis, or septic shock. Further objectives were to evaluate the correlation between the clearance of MR-proADM and the variables of microcirculation and between MR-proADM and the Sequential Organ Failure Assessment (SOFA) score.Materials and Methods: This is a prospective observational pilot study. Inclusion criteria: consecutive adult patients admitted to intensive care unit (ICU) for or with infection-related illness. Daily measurement of MR-proADM and calculation of the SOFA score from admission in ICU to day 5. Repeated evaluations of sublingual microcirculation, collection of clinical data, and laboratory tests.Results: Primary outcome: MR-proADM was not significantly correlated to the MFI at admission in ICU. A clearance of MR-proADM of 20% or more in the first 24 h was related to the improvement of the MFIs and MFIt [percentual variation of the MFIs + 12.35 (6.01–14.59)% vs. +2.23 (−4.45–6.01)%, p = 0.005; MFIt +9.09 (4.53–16.26)% vs. −1.43 (−4.36–3.12)%, p = 0.002].Conclusion: This study did not support a direct correlation of MR-proADM with the MFI at admission in ICU; however, it showed a good correlation between the clearance of MR-proADM, MFI, and other microvascular variables. This study also supported the prognostic value of the marker. Adequately powered studies should be performed to confirm the findings. |
| format |
article |
| author |
Roberta Domizi Elisa Damiani Elisa Damiani Claudia Scorcella Andrea Carsetti Andrea Carsetti Paolo Giaccaglia Paolo Giaccaglia Erika Casarotta Erika Casarotta Jonathan Montomoli Jonathan Montomoli Vincenzo Gabbanelli Marina Brugia Marco Moretti Erica Adrario Erica Adrario Abele Donati Abele Donati |
| author_facet |
Roberta Domizi Elisa Damiani Elisa Damiani Claudia Scorcella Andrea Carsetti Andrea Carsetti Paolo Giaccaglia Paolo Giaccaglia Erika Casarotta Erika Casarotta Jonathan Montomoli Jonathan Montomoli Vincenzo Gabbanelli Marina Brugia Marco Moretti Erica Adrario Erica Adrario Abele Donati Abele Donati |
| author_sort |
Roberta Domizi |
| title |
Mid-Regional Proadrenomedullin (MR-proADM) and Microcirculation in Monitoring Organ Dysfunction of Critical Care Patients With Infection: A Prospective Observational Pilot Study |
| title_short |
Mid-Regional Proadrenomedullin (MR-proADM) and Microcirculation in Monitoring Organ Dysfunction of Critical Care Patients With Infection: A Prospective Observational Pilot Study |
| title_full |
Mid-Regional Proadrenomedullin (MR-proADM) and Microcirculation in Monitoring Organ Dysfunction of Critical Care Patients With Infection: A Prospective Observational Pilot Study |
| title_fullStr |
Mid-Regional Proadrenomedullin (MR-proADM) and Microcirculation in Monitoring Organ Dysfunction of Critical Care Patients With Infection: A Prospective Observational Pilot Study |
| title_full_unstemmed |
Mid-Regional Proadrenomedullin (MR-proADM) and Microcirculation in Monitoring Organ Dysfunction of Critical Care Patients With Infection: A Prospective Observational Pilot Study |
| title_sort |
mid-regional proadrenomedullin (mr-proadm) and microcirculation in monitoring organ dysfunction of critical care patients with infection: a prospective observational pilot study |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/1251d9bc398f41e3b9ba7febdcebce0a |
| work_keys_str_mv |
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