Pilot Trial Evaluating Mid-Regional Pro-Atrial Natriuretic Peptide as a Marker of Sepsis after Abdominal Surgery
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Mid-regional pro-atrial natriuretic peptide (MR pro-ANP) has been shown to be a diagnostic marker for sepsis. The objective of this pilot study was to evaluate the potential of MR pro-ANP in the diagnosis of postoperative sepsis.
We enrolled 18 patients with postoperative sepsis, 19 patients who underwent major abdominal surgery without sepsis and 9 healthy individuals as control subjects. MR pro-ANP, interleukin-6 (IL-6) and procalcitonin (PCT) were measured on the day of inclusion in the study, and at days 3, 7 and 10.
The mean levels of MR pro-ANP were significantly higher in patients with postoperative sepsis than in patients without sepsis (two-way ANOVA p <0.0001). The best cut-off level for MR pro-ANP was determined to be 162.5 pmol/l, with a sensitivity of 100% and specificity of 68%. On the day of inclusion in the study, MR pro-ANP detected postoperative sepsis equally as well as PCT (Youden test P = 0.17). MR pro-ANP levels in patients with postoperative sepsis remained significantly elevated for 10 days, regardless of the clinical state, whereas falling levels of IL-6 and PCT indicated improvement of sepsis. The overall correlation of MR pro-ANP with IL-6 and PCT was therefore low (Pearson´s r 0.15 and 0.36, respectively).
MR pro-ANP may contribute to the diagnosis of postoperative sepsis, as its level can differentiate between elevation of other inflammatory markers due to abdominal surgery alone or postoperative sepsis.
Key wordsSepsis markers mid-regional pro-atrial natriuretic peptide (MR pro-ANP) abdominal surgery postoperative sepsis
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