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• W2332333258 abstract "Study Objectives: In sepsis condition, serum hemopexin levels are correlated to patient's prognosis in some study, but there is little evidence about that. The purpose of this study is to identify the prognostic power of hemopexin from clinical study in septic shock patients and to identify differences in change of serum hemopexin level pursuant to the sepsis severity from pre-clinical study. Methods: 1.Clinical study: A prospective, cohort study conducted in an emergency intensive care unit of a tertiary referral hospital. We enrolled consecutive patients who were admitted to the emergency intensive care unit with septic shock from February 2006 to May 2010. After collecting data with respect to demographic findings, diagnosis, APACHE II scores, basal lactic acid and 28 days mortality, the enrolled patients were divided into 2 groups according to the mortality, 28 days survival groups (survivors) and 28 days death groups (non-survivors). We measured septic enrolled patients' serum hemopexin levels at the time of admission to the ICU 2. Pre-clinical study: Male Spraque-Dawley rats (300-400g) were used. Rats were categorized into 3 groups; 1) Control (n=6, normal saline), 2) low grade sepsis group (n=18, 5mg/kg LPS), 3) high grade sepsis group (n=20, 10mg/kg LPS). Rats of each group were infused saline, LPS and then we checked the serum hemopexin levels, TNF-α, IL-6 by time course (1, 3, 6 hours). Results: 1. Clinical study: Among 142 enrolled patients, 100 were survivors and 42 were non-survivors. The APACHE II score and initial lactic acid level of survivors were lower than non survivors. (respectively p<0.001, p<0.001). Initial serum hemopexin level of non-survivors was lower than that of non-survivors (p<0.001). The area under curve (AUC) of the hemopexin was 0.754 (95% confidence interval, 0.670 - 0.839). In multivariate logistic regression, hemopexin levels have inverse relationship with 28 days mortality (p=0.032). 2. Pre-clinical study: There are significant differences in change in serum hemopexin levels between high grade sepsis group and low grade sepsis group (p=0.013). Especially, serum hemopexin levels of high grade sepsis groups at 6 hours are significant lower than low grade sepsis group (p=0.002). Also, there are significant differences in change in serum TNF-α levels between 2 groups (p<0.001). Serum TNF-α levels of high grade sepsis groups at 3, 6 hours are significant higher than low grade sepsis group (p=0.002 3h, p=0.002 6h). Finally, there are significant differences in change in serum IL-6 levels between 2 groups (p<0.001). Serum IL-6 levels of high grade sepsis groups at 1, 3, 6 hours are significant higher than low grade sepsis group (p=0.026 1h, p=0.026 3h, p=0.002 6h). Conclusion: Initial low serum hemopexin concentration is significantly associated with higher 28 days mortality of patients with septic shock. In pre-clinical study, there are significant in change of serum hemopexin levels pursuant to the sepsis severity. Especially, serum hemopexin levels of high grade sepsis groups at 6 hours are significant lower than low grade sepsis group after LPS infusion." @default.
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• W2332333258 date "2012-10-01" @default.
• W2332333258 modified "2023-09-26" @default.
• W2332333258 title "55 Change of Hemopexin Level Is Associated With the Severity of Sepsis in Endotoxemic Rat Model and the Outcome of Septic Patients" @default.
• W2332333258 doi "https://doi.org/10.1016/j.annemergmed.2012.06.334" @default.
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