Loading...
Publication
Estudo da utilização de marcadores bioquímicos no diagnóstico de Sépsis
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 3.23 MB | Adobe PDF |
Authors
Abstract(s)
A sépsis apresenta vários graus de gravidade. Pode provocar sinais e sintomas ligeiros ou poderá levar a choque, falência de múltiplos órgãos e até à morte. Apesar dos avanços na medicina, a sépsis continua a ser um problema comum em pacientes críticos, sendo uma das principais causas de morte nestes pacientes. Atraso no diagnóstico e início da terapia antibiótica aumenta a mortalidade e morbilidade, prolongando o internamento e tratamento, com os respetivos custos sócio-económicos associados. O seu diagnóstico por vezes pode ser desafiante. Sabendo que o organismo reage bioquimicamente às infeções bacterianas, a utilização de marcadores bioquímicos poderá ser vantajoso para auxiliar no diagnóstico de sépsis. Neste estudo foram doseados alguns marcadores bioquímicos comummente analisados no laboratório hospitalar, com o intuito de determinar se algum se adeque ao diagnóstico de sépsis. Para tal, foi doseado a concentração sérica de bilirrubina total (TBil), bilirrubina indireta (IBil), bilirrubina direta (DBil), procalcitonina (PCT), proteína C reativa (PCR) e lactato (LACT), em 100 indivíduos saudáveis, que constituiu o grupo controlo e 200 indivíduos distribuídos por quatro subgrupos, Septicémia (20 indivíduos), Sépsis (52 indivíduos), Sépsis grave (41 indivíduos) e Choque séptico (87 indivíduos), que constituiu o grupo patológico. A concentração sérica de TBil (2,95 ± 7,64 mg/dL), IBil (1,13 ± 1,76 mg/dL) e DBil (1,82 ± 5,96 mg/dL), PCT (35,26 ± 36,25 ng/mL) e de PCR (240,36 ± 120,25 mg/L) foram mais elevadas no subgrupo Sépsis grave. Quanto ao LACT, o subgrupo Choque séptico apresentou a concentração sérica mais elevada (5,11 ± 4,95 mmol/L). A percentagem de mortalidade aumentou de acordo com a severidade de sépsis. De entre os marcadores estudados, o melhor para a deteção de sépsis foi a PCR, que obteve uma sensibilidade de 100% e uma especificidade de 99,5%, seguido pela PCT, com uma sensibilidade de 100% e uma especificidade de 92,5%.
Sepsis has varying degrees of severity. It may produce mild signs and symptoms or may lead to shock, multiple organ failure and even death. Despite the advances in medicine, sepsis remains a common problem in critically ill patients and is also a leading cause of death in these patients. Delay in diagnosis and initiation of antibiotic therapy increases mortality and morbidity, leads to prolonged hospitalization and treatment, with associated socioeconomic costs. The diagnosis sometimes can be challenging. Knowing that the organism reacts biochemically to bacterial infections, the use of biochemical markers may be advantageous to aid in the diagnosis of sepsis. In this study, some biochemical markers commonly analyzed in the hospital laboratory were dosed, in order to determine if any would be fit for the diagnosis of sepsis. The serum concentration of total bilirubin (TBil), indirect bilirubin (IBil), direct bilirubin (DBil), procalcitonin (PCT), C-reactive protein (CRP) and lactate (LACT) was measured in a 100 healthy individuals, constituting the control group and 200 individuals divided into four subgroups, Septicemia (20 individuals), Sepsis (52 individuals), Severe sepsis (41 individuals) and Septic shock (87 individuals), which constituted the pathological group. The serum concentration of TBil (2,95 ± 7,64 mg/dL), IBil (1,13 ± 1,76 mg/dL) and DBIL (1,82 ± 5,96 mg/dL), PCT (35, 26 ± 36,25 ng/mL) and CRP (240,36 ± 120,25 mg/L) were higher in the Severe sepsis subgroup. Regarding LACT, the Septic shock subgroup had the highest serum concentration (5,11 ± 4,95 mmol/L). The percentage of mortality increased according to the severity of sepsis. Among the markers studied, the best for the detection of sepsis was CRP, which obtained a sensitivity of 100% and a specificity of 99,5%, followed by PCT, with a sensitivity of 100% and a specificity of 92,5 %.
Sepsis has varying degrees of severity. It may produce mild signs and symptoms or may lead to shock, multiple organ failure and even death. Despite the advances in medicine, sepsis remains a common problem in critically ill patients and is also a leading cause of death in these patients. Delay in diagnosis and initiation of antibiotic therapy increases mortality and morbidity, leads to prolonged hospitalization and treatment, with associated socioeconomic costs. The diagnosis sometimes can be challenging. Knowing that the organism reacts biochemically to bacterial infections, the use of biochemical markers may be advantageous to aid in the diagnosis of sepsis. In this study, some biochemical markers commonly analyzed in the hospital laboratory were dosed, in order to determine if any would be fit for the diagnosis of sepsis. The serum concentration of total bilirubin (TBil), indirect bilirubin (IBil), direct bilirubin (DBil), procalcitonin (PCT), C-reactive protein (CRP) and lactate (LACT) was measured in a 100 healthy individuals, constituting the control group and 200 individuals divided into four subgroups, Septicemia (20 individuals), Sepsis (52 individuals), Severe sepsis (41 individuals) and Septic shock (87 individuals), which constituted the pathological group. The serum concentration of TBil (2,95 ± 7,64 mg/dL), IBil (1,13 ± 1,76 mg/dL) and DBIL (1,82 ± 5,96 mg/dL), PCT (35, 26 ± 36,25 ng/mL) and CRP (240,36 ± 120,25 mg/L) were higher in the Severe sepsis subgroup. Regarding LACT, the Septic shock subgroup had the highest serum concentration (5,11 ± 4,95 mmol/L). The percentage of mortality increased according to the severity of sepsis. Among the markers studied, the best for the detection of sepsis was CRP, which obtained a sensitivity of 100% and a specificity of 99,5%, followed by PCT, with a sensitivity of 100% and a specificity of 92,5 %.
Description
Keywords
Sépsis Marcadores bioquímicos Procalcitonina Proteína C reativa Lactato Biochemical markers Procalcitonin C-reactive protein Lactate Bioquímica Aplicada . Faculdade de Ciências Exatas e da Engenharia