Bactericidal/permeability-increasing protein (BPI) in sepsis correlates with the severity of sepsis and the outcome.
OBJECTIVE
To compare the prognostic significance of bactericidal/permeability-increasing protein (BPI), group II phospholipase A2 (PLA2-II), C-reactive protein (CRP), tumour necrosis factor-alpha (TNF), interleukin-8 (IL-8) and interferon-gamma (IFN) in terms of predicting severity of sepsis and outcome.


METHODS
A prospective study.


METHODS
Medical intensive care unit (ICU) of a university hospital.


METHODS
Thirty-four patients with severe sepsis requiring ICU treatment.


RESULTS
The levels of BPI, PLA2-II, CRP, TNF, IL-8 and IFN were measured in these 34 patients. High levels of BPI were associated particularly with Gram-negative sepsis. BPI and BPI/neutrophil ratios correlated positively with PLA2-II, CRP, TNF and IL-8 and negatively with blood pressure. At 24 h, BPI/neutrophil ratios, IL-8 and Simplified Acute Physiology Scores II (SAPS II) scores were higher in non-survivors than in survivors. No such associations were noted in the levels of CRP, PLA2-II, TNF or IFN. The areas under the curve (AUC(ROC)s) of SAPS II scores and IL-8 were higher than AUC(ROC) of BPI/neutrophil ratio.


CONCLUSIONS
The BPI and BPI/neutrophil ratios may serve as adjunctive tools to illustrate the severity of sepsis. However, their predictive power for sepsis-related death was not comparable to that of SAPS II scores and IL-8.
Rintala
E
E
Department of Medicine, Satakunta Central Hospital, Pori, Finland. esa.rintala@satshp.fi
Peuravuori
H
H
Pulkki
K
K
Voipio-Pulkki
L M
LM
Nevalainen
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D023181:Antimicrobial Cationic Peptides; D019540:Area Under Curve; D001798:Blood Proteins / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007371:Interferon-gamma / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D010741:Phospholipases A / Q000378:metabolism; D054467:Phospholipases A2; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood* / Q000382:microbiology; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D023181:Antimicrobial Cationic Peptides; D001798:Blood Proteins; D016209:Interleukin-8; D008565:Membrane Proteins; D014409:Tumor Necrosis Factor-alpha; C021623:bactericidal permeability increasing protein; D007371:Interferon-gamma; D002097:C-Reactive Protein; D010741:Phospholipases A; D054467:Phospholipases A2