Cysteinyl-leukotriene generation as a biomarker for survival in the critically ill.
OBJECTIVE
To evaluate the capacity of cysteinyl-leukotriene generation in the progression of critical illness compared with that in healthy volunteers and to clarify interrelationships between the rate of leukotriene generation, severity of the disease, and clinical outcome.


METHODS
Prospective, observational study.


METHODS
Surgical intensive care unit (ICU) in a German university hospital.


METHODS
We studied 14 ICU patients (nine men, five women; aged 42-82 yrs) suffering from systemic inflammatory response syndrome, sepsis, or sepsis syndrome, with a calculated sepsis severity score of 17.7+/-4.2 and a Simplified Acute Physiology score of 17.6+/-3.0. In addition, five healthy volunteers (three men, two women; aged 34-38 yrs) were included in the study.


METHODS
None.


RESULTS
Blood samples were obtained every second day from septic patients until discharge from the ICU or death. Leukotriene C4 (LTC4) synthesizing capacity was assessed in isolated and stimulated leukocytes (Ca-ionophore) by using combined reversed-phase, high-pressure liquid chromatography and radioimmunoassay methods. Initially, all patients synthesized less LTC4 than the healthy subjects. In patients who did not survive, the low LTC4 generation persisted throughout the observation period, whereas in surviving patients, its formation was normalized during convalescence. In surviving patients, LTC4 concentrations correlated with sepsis severity score.


CONCLUSIONS
LTC4 generation is impaired in sepsis and may serve as a biomarker for survival in the critical ill.
Morlion
B J
BJ
Department of Anesthesiology, Multidisciplinary Pain Center, University Hospital Leuven, Belgium.
Torwesten
E
E
Kuhn
K S
KS
Puchstein
C
C
Fürst
P
P
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003422:Critical Care; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000276:immunology; D017997:Leukotriene C4 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012016:Reference Values; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality
D015415:Biomarkers; D017997:Leukotriene C4