Value Of Pro-adrenomedullin Research Articles

Proadrenomedullin and neonatal sepsis: a systematic review and meta-analysis of diagnostic accuracy.

The association of proadrenomedullin and neonatal sepsis has been examined in numerous studies. The object of our meta-analysis is to evaluate differences in proadrenomedullin among neonates with sepsis and health neonates. We systematically searched the following databases: MEDLINE, Clinicaltrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, and WHO (International Clinical Trials Register Platform) using a structured algorithm. Statistical analysis was conducted using Revman 5.3 and R software. Included studies in the meta-analysis were assessed using the Newcastle-Ottawa scale. Proadrenomedullin levels were found significantly higher in neonates with sepsis than healthy neonates with an SMD equal with 3.07 [95% CI 1.71, 4.42 (p < 10-5, I2 = 98%)]. The optimal cutoff point of pro-ADM was calculated at 17.559 with a sensitivity of 0.879 (0.458; 0.984) and a specificity of 0.994 (0.820; 1.000), and an AUC of 0.905. Subgroup analysis, leave-one-out meta-analysis, and meta-regression were performed in an effort to lower inter-study heterogeneity. Sensitivity analysis was conducted by excluding high risk of bias studies and those contributing to the overall heterogeneity shown by the Baujat plot. Publication bias was assessed using a funnel plot and the trim-and-fill method. Certainty assessment was evaluated using the GRADE score.Conclusion: The findings of our meta-analysis suggest that proadrenomedullin is elevated in neonates with sepsis. However, future prospective cohort studies need to be conducted in order to assess its diagnostic accuracy. What is Known: • Proadrenomedullin has been found increased in adult patients with infectious diseases such as community acquired pneumonia. • Proadrenomedullin plays a major role in the pathophysiology of sepsis in adults. What is New: • Proadrenomedullin is increased in neonates with sepsis. • Future cohort studies need to be conducted in order to elucidate the value of proadrenomedullin in a safer way.

Value of Pro-Adrenomedullin in Critically Ill Septic Children in Zagazig University Hospital

Introduction: Sepsis is a life-threatening condition which affects many children regardless of some underlying healthcare issues. Assessment risk of mortality in critically ill septic children in pediatric intensive care units (PICUs) can be done by measuring levels of certain new biomarkers. Adrenomedullin (ADM) has been recently proposed as a useful biomarker for evaluating disease severity and risk of death.Objective: The purpose of this study was to measure sensitivity and specificity of ADM in assessment risk of mortality in septic children in comparison to other traditionally used biomarkers in PICUs as CRP and procalcitonin.Method: A prospective Cross sectional study was carried out at pediatric intensive care unit of the pediatric Department and clinical pathology department at Zagazig University Children Hospitals during the period from July 2018 to January 2019 , Thirty eight infant and children patients were recruited in the study ,they were selected from the pediatric intensive care unit population who suffered septicemia ,blood samples withdrawn to measure sepsis markers as ADM , CRP and PCT.Results: There is statistically significant difference between the outcome of the studied patients and our biomarkers CRP, procalcitonin and ADM levels, we found that sensitivity of ADM 83.3%, specificity was 75% PCT sensitivity was 77.8% and specificity was 65% however 72.2% sensitivity, 65% specificity of CRP.Conclusion: MR-pro-ADM level have shown higher positive-predictive values than PCT and CRP levels with high sensitivity and specificity so , this study came to support MR-pro-ADM as new biomarker in critically ill septic children.

Prognosis value of biomarkers in severe sepsis and septic shock

The purpose of the study was to assess the prognosis value of pro-adrenomedullin (pADM), C-reactive protein (CRP) and procalcitonin (PCT), lactate (LT), albumin (ALB), cholesterol (CHOL), white blood cell (WBC) and severity score in patients with severe sepsis or septic shock.

Pro-adrenomedullin as prognostic biomarker in the sepsis

Measurement of biomarkers is a potential approach to early assessment and prediction of mortality in septic patients. The purpose of this study was to ascertain the prognostic value of pro-adrenomedullin (pADM), measured in all patients admitted to the ICU of our hospital with a diagnosis of severe sepsis or septic shock during 1 year.

Prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumonia

Community-acquired pneumonia (CAP) is the leading cause of death from infectious disease in western countries and supposes an important consumption of healthcare resources. Several studies suggest that proADM is possibly as good as validated severity scores in detecting critically ill patients with CAP and probably better than other biomarkers like procalcitonin (PCT).