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2016 ; 20
(1
): 363
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English Wikipedia
Mid-regional pro-adrenomedullin (MR-proADM), a marker of positive fluid balance
in critically ill patients: results of the ENVOL study
#MMPMID27825364
Vigué B
; Leblanc PE
; Moati F
; Pussard E
; Foufa H
; Rodrigues A
; Figueiredo S
; Harrois A
; Mazoit JX
; Rafi H
; Duranteau J
Crit Care
2016[Nov]; 20
(1
): 363
PMID27825364
show ga
BACKGROUND: The optimal control of blood volume without fluid overload is a main
challenge in the daily care of intensive care unit (ICU) patients. Accordingly
this study focused on the identification of biomarkers to help characterize fluid
overload status. METHODS: Sixty-seven patients were studied from ICU admission to
day 7 (D(7)). Blood and urine samples were taken daily and sodium and water
balance strictly calculated resulting in a total cumulative assessment of ?Na(+)
and ?H(2)O. Furthermore, plasmatic biomarkers (cortisol, epinephrine,
norepinephrine, renin, angiotensin II, aldosterone, pro-endothelin, copeptine,
atrial natriuretic peptide, erythropoietin, mid-regional pro-adrenomedullin
(MR-proADM)) and Sequential Organ Failure Assessment (SOFA) scores were measured
at D(2), D(5) and D(7). Blood volumes were measured with (51)Cr fixed on red
blood cells at D(2) and D(7). RESULTS: The ?Na(+) or ?H(2)O were increased in all
patients but never related to blood volumes at D(2) nor D(7). Total blood volumes
were at normal values with constantly low red blood cell volumes and normal or
decreased plasmatic volume. Weight, plasmatic proteins, and hemoglobin were
weakly related to ?Na(+) or ?H(2)O. Amongst all tested biomarkers, only MR-proADM
was related to sodium and fluid overload. This biomarker was also a predictor of
SOFA scores. CONCLUSIONS: Plasmatic concentration in MR-proADM seems to be a good
surrogate for evaluation of ?Na(+) or ?H(2)O and predicts sodium and
extracellular fluid overload. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01858675
in May 13, 2013.