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Shock
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e studied the putative predictive value of plasma cf-DNA/NETs for the development of sepsis and mortality after multiple trauma. In a prospective pilot study with 45 multiple trauma (Injury Severity Score >16) patients, cf-DNA was directly quantified in plasma. Blood samples were sequentially obtained daily from admission to our Trauma Center until day 10. Because of limited intensive care unit (ICU) stay of less than 3 days, 8 patients have been excluded, resulting in 37 patients that were evaluated. Time kinetics of cf-DNA/NETs was compared with C-reactive protein (CRP), interleukin (IL) 6, leukocyte counts, and myeloperoxidase. The severity of the injury was calculated on the basis of the Injury Severity Score, as well as Multiple Organ Dysfunction Score, Sequential Organ Failure Assessment, and Simplified Acute Physiology Score II on ICU. Initially high cf-DNA/NETs values (>800 ng/mL) with recurrent increased values between days 5 to 9 were associated with subsequent sepsis, multiple organ failure, and death. In conjunction with cf-DNA/NETs, IL-6 was significantly elevated after admission. However, the development of a second hit was not indicated by IL-6. In contrast to cf-DNA/NETs, no difference in CRP kinetics was observed between patients with and without development of sepsis. Circulating free DNA/NETs kinetics rather followed kinetics of Multiple Organ Dysfunction Score, Sepsis-related Organ Failure Assessment, leukocyte counts, and partially of myeloperoxidase. Circulating free DNA/NETs seems to be a valuable additional marker for the calculation of injury severity and/or prediction of inflammatory second hit on ICU. However, a large clinical trial with severely injured patients should confirm the prognostic value of neutrophil-derived cf-DNA/NETs....
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Keywords {🔍}
cfdnanets, patients, kinetics, values, time, types, type, iii, sepsis, days, organ, ngml, data, significant, trauma, day, fig, score, failure, multiple, blood, study, admission, injury, samples, icu, shown, range, neutrophil, neutrophils, free, nets, crp, found, journal, circulating, severe, iss, control, group, differences, statistically, initial, clinical, dna, development, inflammatory, plasma, severity, obtained,
Topics {✒️}
target neutrophil-derived cf-dna/nets neutrophil-derived cf-dna/nets correlate cf-dna/nets patterns platelet-mediated net-inducing mechanism circulating free dna/nets cf-dna/nets values decreased low cf-dna/nets values cf-dna/nets kinetics type cf-dna/nets plasma values cf-dna/nets values ranged iii cf-dna/nets kinetics cf-dna/nets kinetics types cf-dna/nets time kinetics cf-dna/nets type iii label neutrophil-derived nets neutrophil cytoplasm-derived proteins cf-dna/nets formation cf-dna largely derives cf-dna/nets kinetics cf-dna/nets values plasma cf-dna/nets evaluate organ dysfunction/failure cf-dna/nets type cf-dna/nets measurement blood-brain barrier dysfunction circulating free dna nets bind gram-positive neutrophil-mediated posttraumatic pathophysiology cf-dna/nets assay heinrich-heine university hospital cf-dna/nets neutrophil-derived elastase cf-dna directly 0b013e31816a6bb1 free abstract acute renal failure iii significantly differed neutrophil extracellular traps neutrophil effector functions multiple organ failure post hoc test upper confidence limits view full text clinical score evaluation exposed neutrophil enzymes revealed initially enhanced neutrophil hyporeactiveness related statistically significant differences intensive care unit showed statistical significance journal authors submit
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