Abstract
BackgroundThe soluble CD14 subtype, Presepsin, appears to be an accurate sepsis diagnostic marker, but data from intensive care units (ICUs) are scarce. This study was conducted to evaluate the diagnostic and prognostic value of Presepsin in ICU patients with severe sepsis (SS), septic shock (SSh) and severe community-acquired pneumonia (sCAP).MethodsPresepsin and procalcitonin (PCT) levels were determined for patients at admission to ICU. Four groups have been differentiated: (1) absence or (2) presence of systemic inflammatory response syndrome, (3) SS or (4) SSh; and 2 groups, among the patients admitted for acute respiratory failure: absence or presence of sCAP. Biomarkers were tested for diagnosis of SS, SSh and sCAP and for prediction of ICU mortality.ResultsOne hundred and forty-four patients were included: 44 SS and 56 SSh. Plasma levels of Presepsin and PCT were significantly higher in septic than in non-septic patients and in SSh as compared to others. The sepsis diagnostic accuracy of Presepsin was not superior to that of PCT (AUC: 0.75 vs 0.80). In the 72/144 patients admitted for acute respiratory failure, the capability of Presepsin to diagnose sCAP was significantly better than PCT. Presepsin levels were also predictive of ICU mortality in sepsis and in sCAP patients.ConclusionPlasma levels of Presepsin were useful for the diagnosis of SS, SSh and sCAP and may predict ICU mortality in these patients.
Highlights
The soluble CD14 subtype, Presepsin, appears to be an accurate sepsis diagnostic marker, but data from intensive care units (ICUs) are scarce
We aimed to evaluate the diagnostic and prognostic utility of Presepsin measurements for severe community-acquired pneumonia in the subgroup of patients admitted to the ICU with acute respiratory failure
We extended our analysis to patients admitted for acute respiratory failure (ARF) and found that both Presepsin and PCT levels were significantly higher in patients with severe community-acquired pneumonia (sCAP) (Fig. 2c, d)
Summary
The soluble CD14 subtype, Presepsin, appears to be an accurate sepsis diagnostic marker, but data from intensive care units (ICUs) are scarce. This study was conducted to evaluate the diagnostic and prognostic value of Presepsin in ICU patients with severe sepsis (SS), septic shock (SSh) and severe community-acquired pneumonia (sCAP). Plasma Presepsin levels could be useful for diagnosis and prognosis of sepsis and for monitoring the course of the disease [8, 9]. Most of these studies have been, performed in settings of emergency departments [10,11,12,13], and data from intensive care units (ICUs) are scarce. The new development of a fully automated point of care assay for rapid whole-blood Presepsin measurement updated its clinical use in emergency and ICUs [8, 11, 17]
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