Circulating intercellular adhesion molecule-1 as an early predictor of hepatic failure in patients with septic shock.

摘要: Objective: To investigate whether endotoxin, interleukin-6, and circulating adhesion molecules, measured sequentially in blood, can predict mortality organ dysfunction sepsis. Design: Inception cohort study with follow-up for 28 days. Setting: Surgical intensive care unit at a university hospital. Patients: A total of 14 consecutive patients were enrolled the within first 24 hrs after onset septic shock. Seven healthy subjects studied as controls. Interventions: Patients analyzed development dysfunction. Measurements Main Results: At end 28-day period, seven still alive (survivors) but other (nonsurvivors) had died. time enrollment (day 0), Acute Physiology Chronic Health Evaluation II score was 28.4 survivors (n = 7) 28.7 nonsurvivors 7). In contrast, intercellular molecule-1 (ICAM-1) significantly higher non-survivors than survivors. Circulating ICAM-1 predicted shock sensitivity specificity 71.4% each. Endotoxin, L-selectin, P-selectin, E-selectin, platelet endothelial cell molecule-1, however, did not distinguish between nonsurvivors. addition, day 0 showed significant correlation highest serum bilirubin observed during entire period (r 2 0.963). Conclusions: Because only 0, may serve an early prognostic marker outcome measurement facilitates identification those risk developing liver