الفهرس | Only 14 pages are availabe for public view |
Abstract S epsis is a major cause of morbidity and mortality in intensive care units (ICU) worldwide. The incidence of sepsis is increasing and it is as high as the incidence of myocardial infarctions. The mortality rate has been reported at 20 to 50 per cent, most of which are attributed to cardiovascular collapse. Several studies have been performed to identify biomarkers for use in the early identification of patients at risk. Over all the natriuretic peptides, presently BNP is the most promising nominee for prediction of sepsis severity, as it is secreted secondary to volume overload and ventricular wall stretching by cardiomyocytes. Also it reflects hemodynamic abnormalities. This study was done to estimate and evaluate the plasma levels of BNP in patients with sepsis and to study the association of BNP levels with severity of disease progression and prognosis of those patients. This prospective cohort study was conducted on 30 patients admitted to intensive care unit at October 6 university hospital in the period from June 2018 to January 2019 with diagnosis of sepsis. Regarding complete blood picture, there was significant decrease in haemoglobin in those who did not survive. There was significant decrease in serum sodium in those who did not survive. Serum lactate and CRP were significantly high in those who did not survive. As regard BNP, it was significantly higher in the non-survivor group, Also it correlated with prolonged length of stay in ICU, progressing to septic shock and need of mechanical ventilation. Regarding the ROC curve result the best cut-off of BNP to predict mortality was >300pg/ml, with Area under the curve = 0.764, Sensitivity = 66.67%, Specificity= 93.33%, positive predictive value = 90.9% and negative predictive value =73.7% Regarding the ROC curve result the best cut-off of Serum lactate to predict mortality was >2mmol/L, with Area under the curve = 0.709, Sensitivity = 60.0%, Specificity= 80.0%, positive predictive value = 75.0% and negative predictive value =66.7% |