الفهرس 
Incidence, Pathogenesis, Diagnosis and Management of SepsisOnly 14 pages are availabe for public view
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Abstract
Adiponectin as a Predictor for the Severity of Sepsis in ICU Patients
Mohammed Amin M.Sc., Dr. Nahed Salah Eldin M.D.,* Dr. Sherif Wadie M.D.,Dr. Mervat El Damarawy M.D.,Dr. Fady Adieb M.D.and Dr.Ashraf AbdelKhaleq M.D.
Anesthesia and Intensive Care Medicine Depart, Ain Shams University, and *Intensive Care Medicine Depart, Theodor Bilharz Research Institute.
Abstract
Background: Sepsis is widely diagnosed In ICU patients. The sepsis markers are numerous with variable sensitivity & specificity. Adiponectin is a protein hormone that modulates a number of metabolic processes, exclusively secreted from adipose tissue into the bloodstream , it’s a key substance in metabolic syndrome & it is known to have anti-inflammatory properties. The relationship between adiponectin and sepsis in vivo is unclear.
In the current study we aim to demonstrate that low plasma adiponectin level could be an early predictor for morbidity & mortality of sepsis by its comparison with C-reactive protein, S.lactate & procalcitonine.
Methods: 30 patients admitted to the intensive care unit with picture clinically suggesting sepsis were enrolled in the study. Predisposition, insult/infection, response, and organ dysfunction (PIRO) score was used to follow the course of the septic process. Plasma adiponectin level, Serum lactate level, Procalcitonine level(PCT), C-reactive protein(CRP) were checked on day1 then day 4 then day 7 & so on until ICU discharge or demise for a total of 28 days .
Results: PIRO score was able to expect sepsis prognosis with high statistical significance. Procalcitonin, S.Lactate & Adiponectin were valuable in follow up the sepsis prognosis with P value (0, 0.01 & 0 respectively) on the contrary CRP had poor prognostic value in sepsis follow up (P value 0.16).
Conclusion: PIRO score is an effective model for staging of sepsis & seems to be predictive of mortality. Measuring serial procalcitonin levels may be the most useful in order to understand the trend, identify the peak, and be able to identify resolution of sepsis. Early high lactate level is a predictor for poor prognosis of sepsis. Adiponectin is similar to procalcitinin in early detection of sepsis & can be used as a prognostic indicator with considering that adiponectin level could be affected by other metabolic disorders.
Key words: Sepsis, sepsis markers, PIRO score, Adiponectin