Multiple Biomarkers to Assess the Pathophysiological State in Critically Ill Patients with Sepsis

Area of Science:

• Biochemistry
• Critical Care Medicine
• Pathophysiology

Background:

• Sepsis triggers metabolic disturbances due to inflammation, ischemia, and oxidative stress.
• Key indicators include procalcitonin (PCT), Ischemia Modified Albumin (IMA), pH, and lactate.
• Concomitant sepsis, ischemia, and lactic acidosis can severely impair organ function.

Purpose of the Study:

• To investigate the co-occurrence of sepsis, ischemia, and lactic acidosis in critically ill patients.
• To assess the diagnostic utility of PCT, IMA, pH, and lactate in this population.
• To elucidate the role of oxidative stress in critical illness.

Main Methods:

• Assay of PCT, lactate, and IMA in 26 critically ill patients and 25 healthy controls.
• PCT measured via electro-chemiluminescence; lactate and pH via blood gas analysis.
• IMA quantified spectrophotometrically using the Albumin Cobalt Binding Test; statistical analysis included Student's t-test and Venn diagrams.

Main Results:

• Critically ill patients showed significantly higher IMA levels (0.967 ± 0.734) than controls (0.007 ± 0.009, p < 0.0001).
• All 26 patients had elevated IMA; PCT was elevated in 22, and lactate in 20.
• 17 patients had both elevated PCT and lactate; all patients displayed elevated IMA, suggesting universal oxidative stress.

Conclusions:

• Elevated IMA levels are a consistent finding in critically ill patients, irrespective of sepsis or lactic acidosis.
• IMA serves as a sensitive biomarker for oxidative stress in critical illness.
• Venn diagrams effectively illustrate the concurrent pathophysiological processes in critically ill patients.