PMID- 37441100
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230718
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 7
DP  - 2023 Jul
TI  - The Role of Serum and Peritoneal Biomarkers in Predicting Sepsis and Septic 
      Multiorgan Failure in Patients With Secondary Peritonitis.
PG  - e41724
LID - 10.7759/cureus.41724 [doi]
LID - e41724
AB  - Purpose Secondary peritonitis is still one of the most important causes of severe 
      sepsis in the world; therefore, it is of utmost importance to identify 
      biomarkers that could be employed for the purpose of selecting patients at high 
      risk for developing life-threatening complications after emergency surgery. In 
      view of this quest, our study seeks to reveal the possible role for serum and 
      peritoneal concentrations of selected biomarkers, specifically presepsin, 
      procalcitonin, monocyte chemoattractant protein-1 (MCP-1), high mobility group 
      box 1 protein (HMGB-1) and interleukins (IL-6, -8, -10), in early prediction of 
      sepsis and septic multiorgan failure for patients with secondary peritonitis. 
      Methods We prospectively observed 32 selected patients with secondary peritonitis 
      that underwent emergency surgery. Blood and peritoneal fluid samples were drawn 
      at the time of surgery (T0), and after that, blood samples were taken at 24 (T1) 
      and 48 (T2) hours postoperatively. Cytokines concentrations were determined using 
      a sandwich enzyme-linked immunosorbent assay (ELISA), a non-competitive variant, 
      both in peritoneal fluid and serum. For determining whole blood concentration of 
      presepsin and procalcitonin, PATHFAST assays (Polymedco, Cortlandt, New York) 
      were used, based on the principle of non-competitive chemiluminescent enzyme 
      immune-assay (CLEIA). The study was conducted according to the guidelines of the 
      Declaration of Helsinki and approved by the Ethics Committee of University 
      Emergency Hospital Bucharest (no. 40325/6 April 2023). Results We found 
      significant elevations in the peritoneal concentrations of interleukins 6, 8, 10, 
      HMGB-1, and MCP-1 in all patients with secondary peritonitis at the moment of 
      surgery; however, no clear correlation could be made based on this data with 
      patient evolution. With regards to blood concentrations of the aforementioned 
      serum cytokines and presepsin, procalcitonin (as already established markers of 
      sepsis), our results showed good predictive value of presepsin for developing 
      sepsis and septic multiorgan failure from the first hours in this patient 
      category. All other biomarkers, despite having higher concentrations than 
      baseline, in particular at 24-48 hours after surgery, had unpredictable dynamics 
      that couldn't be correlated with the severity of the disease. Conclusion Cytokine 
      production is the mainstay in developing sepsis and septic multiorgan failure in 
      patients with secondary peritonitis; therefore, studying the dynamics of said 
      cytokines seems of interest in finding tools to predict the development of sepsis 
      or sepsis-related mortality. However, at the time, there seemed to be no clear 
      correlation between the values of these cytokines and the development of 
      complications.
CI  - Copyright (c) 2023, Dumitrascu et al.
FAU - Dumitrascu, Clementina O
AU  - Dumitrascu CO
AD  - Anesthesiology and Critical Care Department, University Emergency Hospital of 
      Bucharest, Bucharest, ROU.
FAU - Gherghe, Mihai
AU  - Gherghe M
AD  - Anesthesiology and Critical Care Department, University Emergency Hospital of 
      Bucharest, Bucharest, ROU.
FAU - Costache, Mihai
AU  - Costache M
AD  - Orthopedics and Traumatology Department, University Emergency Hospital of 
      Bucharest, Bucharest, ROU.
FAU - Cretu, Bogdan
AU  - Cretu B
AD  - Orthopedics and Traumatology Department, University Emergency Hospital of 
      Bucharest, Bucharest, ROU.
FAU - Cirstoiu, Catalin
AU  - Cirstoiu C
AD  - Orthopedics and Traumatology Department, University Emergency Hospital of 
      Bucharest, Bucharest, ROU.
LA  - eng
PT  - Journal Article
DEP - 20230711
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10335813
OTO - NOTNLM
OT  - cytokine storm
OT  - peritoneal cytokines
OT  - secondary peritonitis
OT  - sepsis
OT  - syndrome
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/07/13 19:15
MHDA- 2023/07/13 19:16
PMCR- 2023/07/11
CRDT- 2023/07/13 15:20
PHST- 2023/07/10 00:00 [accepted]
PHST- 2023/07/13 19:16 [medline]
PHST- 2023/07/13 19:15 [pubmed]
PHST- 2023/07/13 15:20 [entrez]
PHST- 2023/07/11 00:00 [pmc-release]
AID - 10.7759/cureus.41724 [doi]
PST - epublish
SO  - Cureus. 2023 Jul 11;15(7):e41724. doi: 10.7759/cureus.41724. eCollection 2023 
      Jul.