Inflammation biomarkers and delirium in critically ill patients

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• 作者：Cristiane Ritter (5) (6)
  Cristiane D Tomasi (5)
  Felipe Dal-Pizzol (5) (6) (7)
  Bernardo Bollen Pinto (8) (9)
  Alex Dyson (8)
  Aline S de Miranda (10)
  Clarissa M Comim (11)
  M谩rcio Soares (12) (13)
  Antonio L Teixeira (10)
  Jo茫o Quevedo (11) (14)
  Mervyn Singer (8)
  
  5. Laborat贸rio de Fisiopatologia Experimental and Instituto Nacional de Ci锚ncia e Tecnologia Translacional em Medicina ; Programa de P贸s-Gradua莽茫o em Ci锚ncias da Sa煤de ; Unidade Acad锚mica de Ci锚ncias da Sa煤de ; Universidade do Extremo Sul Catarinense ; 88806-000 ; Crici煤ma ; SC ; Brazil
  6. Intensive Care Unit ; Hospital S茫o Jos茅 ; Coronel Pedro Benedet ; 630 ; 88801450 ; Crici煤ma ; SC ; Brazil
  7. Departamento de Cl铆nica M茅dica ; Hospital Universetario ; Universidade Federal de Santa Catarina ; 88036-800 ; Florian贸polis ; SC ; Brazil
  8. Bloomsbury Institute of Intensive Care Medicine ; University College London ; Cruciform Building ; Gower Street ; London ; WC1E 6BT ; UK
  9. Graduate Program in Areas of Basic and Applied Biology ; University of Porto ; Rua Dr. Roberto Frias ; s/n ; 4200-465 ; Porto ; Portugal
  10. Grupo de Neuroimunologia ; Laborat贸rio de Imunofarmacologia ; Departamento de Bioqu铆mica e Imunologia ; Instituto de Ci锚ncias Biol贸gicas da UFMG ; Av. Alfredo Balena ; 190 ; 30130-100 ; Belo Horizonte ; MG ; Brazil
  11. Laborat贸rio de Neuroci锚ncias and Instituto Nacional de Ci锚ncia e Tecnologia Translacional em Medicina ; Programa de P贸s-Gradua莽茫o em Ci锚ncias da Sa煤de ; Unidade Acad锚mica de Ci锚ncias da Sa煤de ; Universidade do Extremo Sul Catarinense ; 88806-000 ; Crici煤ma ; SC ; Brazil
  12. Department of Clinical Research ; D鈥橭r Institute for Research and Education ; Rua Diniz Cordeiro ; 30 鈥?3掳 andar ; CEP 22281-100 ; Rio de Janeiro ; RJ ; Brazil
  13. Post-graduation Program ; Instituto Nacional de C芒ncer ; Rua Andr茅 Cavalcante n掳 37/2掳 Andar ; CEP ; 20231-050 ; Rio de Janeiro ; Brazil
  14. Department of Psychiatry and Behavioral Sciences ; Center for Experimental Models in Psychiatry ; The University of Texas Medical School at Houston ; 1941 East Road ; Ste. 3140 ; 77054 ; Houston ; TX ; USA
  
• 刊名：Critical Care
• 出版年：2014
• 出版时间：June 2014
• 年：2014
• 卷：18
• 期：3
• 全文大小：226 KB
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• 刊物主题：Intensive / Critical Care Medicine; Emergency Medicine;
• 出版者：BioMed Central
• ISSN：1364-8535

文摘

Introduction Delirium is a common occurrence in critically ill patients and is associated with an increase in morbidity and mortality. Septic patients with delirium may differ from a general critically ill population. The aim of this investigation was to study the relationship between systemic inflammation and the development of delirium in septic and non-septic critically ill patients. Methods We performed a prospective cohort study in a 20-bed mixed intensive care unit (ICU) including 78 (delirium鈥?鈥?1; non-delirium鈥?鈥?7) consecutive patients admitted for more than 24聽hours. At enrollment, patients were allocated to septic or non-septic groups according to internationally agreed criteria. Delirium was diagnosed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) during the first 72聽hours of ICU admission. Blood samples were collected within 12聽hours of enrollment for determination of tumor necrosis factor (TNF)-伪, soluble TNF Receptor (STNFR)-1 and -2, interleukin (IL)-1尾, IL-6, IL-10 and adiponectin. Results Out of all analyzed biomarkers, only STNFR1 (P鈥?鈥?.003), STNFR2 (P鈥?鈥?.005), adiponectin (P鈥?鈥?.005) and IL-1尾 (P鈥?鈥?.001) levels were higher in delirium patients. Adjusting for sepsis and sedation, these biomarkers were also independently associated with delirium occurrence. However, none of them were significant influenced by sepsis. Conclusions STNFR1, STNFR2, adiponectin and IL-1尾 were associated with delirium. Sepsis did not modify the relationship between the biomarkers and delirium occurrence.