Different Biomarker Kinetics in Critically Ill Patients with High Lactate Levels
We evaluated the association of the kinetics of interleukin-6 (IL-6), neutrophil gelatinase-associated lipocalin (NGAL), and high-mobility group box 1 (HMGB1) with intensive care unit (ICU) mortality in critically ill patients with hyperlactatemia. This proof-of-concept study was conducted with pros...
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MDPI AG
2020-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/10/7/454 |
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| author | Ryo Matsuura Yohei Komaru Yoshihisa Miyamoto Teruhiko Yoshida Kohei Yoshimoto Yoshifumi Hamasaki Masaomi Nangaku Kent Doi |
| author_facet | Ryo Matsuura Yohei Komaru Yoshihisa Miyamoto Teruhiko Yoshida Kohei Yoshimoto Yoshifumi Hamasaki Masaomi Nangaku Kent Doi |
| author_sort | Ryo Matsuura |
| collection | DOAJ |
| description | We evaluated the association of the kinetics of interleukin-6 (IL-6), neutrophil gelatinase-associated lipocalin (NGAL), and high-mobility group box 1 (HMGB1) with intensive care unit (ICU) mortality in critically ill patients with hyperlactatemia. This proof-of-concept study was conducted with prospectively enrolled patients admitted to a medical/surgical ICU with hyperlactatemia (lactate levels >4 mmol/L). Blood lactate, IL-6, NGAL, and HMGB1 were measured every 2 h until 6 h post ICU admission. The primary outcome was ICU mortality. Of thirty patients in this study, 14 patients (47%) had sepsis, and the ICU mortality was 47%. IL-6 and NGAL levels were significantly higher in septic patients than in non-septic patients. On kinetic analysis, the lactate levels were significantly decreased in survivors, and the NGAL levels were significantly increased in non-survivors. Among septic patients, a decline in IL-6 levels were observed in survivors. The HMGB1 levels were unchanged in survivors and non-survivors regardless of sepsis complication. Non-septic patients with higher reduction rate of lactate and HMGB1 had the lowest mortality than the others. ICU patients exhibited different kinetic patterns in lactate, NGAL, and IL-6, but HMGB1 did not seem to change over the 6-h duration. Further studies are necessary to evaluate the efficacy of the combination of the inflammatory biomarkers with lactate. |
| first_indexed | 2024-03-09T06:11:56Z |
| format | Article |
| id | doaj.art-c751679d6d374de793b168ffafe030d2 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T06:11:56Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-c751679d6d374de793b168ffafe030d22023-12-03T11:57:31ZengMDPI AGDiagnostics2075-44182020-07-0110745410.3390/diagnostics10070454Different Biomarker Kinetics in Critically Ill Patients with High Lactate LevelsRyo Matsuura0Yohei Komaru1Yoshihisa Miyamoto2Teruhiko Yoshida3Kohei Yoshimoto4Yoshifumi Hamasaki5Masaomi Nangaku6Kent Doi7Department of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDepartment of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDepartment of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDepartment of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDepartment of Acute Medicine, University Hospital, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDepartment of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDepartment of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDepartment of Acute Medicine, University Hospital, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanWe evaluated the association of the kinetics of interleukin-6 (IL-6), neutrophil gelatinase-associated lipocalin (NGAL), and high-mobility group box 1 (HMGB1) with intensive care unit (ICU) mortality in critically ill patients with hyperlactatemia. This proof-of-concept study was conducted with prospectively enrolled patients admitted to a medical/surgical ICU with hyperlactatemia (lactate levels >4 mmol/L). Blood lactate, IL-6, NGAL, and HMGB1 were measured every 2 h until 6 h post ICU admission. The primary outcome was ICU mortality. Of thirty patients in this study, 14 patients (47%) had sepsis, and the ICU mortality was 47%. IL-6 and NGAL levels were significantly higher in septic patients than in non-septic patients. On kinetic analysis, the lactate levels were significantly decreased in survivors, and the NGAL levels were significantly increased in non-survivors. Among septic patients, a decline in IL-6 levels were observed in survivors. The HMGB1 levels were unchanged in survivors and non-survivors regardless of sepsis complication. Non-septic patients with higher reduction rate of lactate and HMGB1 had the lowest mortality than the others. ICU patients exhibited different kinetic patterns in lactate, NGAL, and IL-6, but HMGB1 did not seem to change over the 6-h duration. Further studies are necessary to evaluate the efficacy of the combination of the inflammatory biomarkers with lactate.https://www.mdpi.com/2075-4418/10/7/454lactateinterleukin-6high-mobility group box 1neutrophil gelatinase-associated lipocalin |
| spellingShingle | Ryo Matsuura Yohei Komaru Yoshihisa Miyamoto Teruhiko Yoshida Kohei Yoshimoto Yoshifumi Hamasaki Masaomi Nangaku Kent Doi Different Biomarker Kinetics in Critically Ill Patients with High Lactate Levels Diagnostics lactate interleukin-6 high-mobility group box 1 neutrophil gelatinase-associated lipocalin |
| title | Different Biomarker Kinetics in Critically Ill Patients with High Lactate Levels |
| title_full | Different Biomarker Kinetics in Critically Ill Patients with High Lactate Levels |
| title_fullStr | Different Biomarker Kinetics in Critically Ill Patients with High Lactate Levels |
| title_full_unstemmed | Different Biomarker Kinetics in Critically Ill Patients with High Lactate Levels |
| title_short | Different Biomarker Kinetics in Critically Ill Patients with High Lactate Levels |
| title_sort | different biomarker kinetics in critically ill patients with high lactate levels |
| topic | lactate interleukin-6 high-mobility group box 1 neutrophil gelatinase-associated lipocalin |
| url | https://www.mdpi.com/2075-4418/10/7/454 |
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