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ORIGINAL ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 3  |  Page : 95-102

Heparin-binding protein as a predictive and diagnostic biomarker for severe sepsis and septic shock in patients with sepsis


1 Department of Anesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt
2 Department of Medical Biochemistry, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Correspondence Address:
Hala E Zanfaly
Assistant Professor of Anesthesia and Intensive Care, Department of Anesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Zagazig
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2356-9115.193408

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Background Detection of impending circulatory failure in a patient with sepsis is critical for modification of the treatment. Heparin-binding protein (HBP) is an inflammatory mediator with an important role in central sepsis mechanism. Design This study was a prospective, randomized, comparative one. Objective The aim of this study was to investigate the serum levels of HBP in patients with sepsis and to assess its value in the early detection of circulatory failure compared with the currently used biomarkers of sepsis. Patients and methods A total of 90 patients with signs of sepsis were prospectively enrolled in this study. After a 12-h study period, 41 patients had signs of sepsis (the sepsis group), 29 patients developed severe sepsis (the severe sepsis group), and 20 patients progressed to septic shock (the septic shock group). Blood samples were collected at enrollment and after 12 h for the measurement of white blood cell count and the serum levels of HBP, procalcitonin, lactate, and C-reactive protein. Vital signs were recorded at the same predetermined times. Results The serum levels of HBP were elevated up to 12 h before signs of circulatory failure were detected in patients with severe sepsis and septic shock. HBP serum level with an area under the curve value of 0.95 at a cutoff point of more than 31.6 ng/ml, sensitivity of 85.7%, specificity of 87.8%, positive predictive value of 89.4%, and negative predictive value of 83.7% was better indicator of circulatory failure compared with the other investigated biomarkers. After 12 h, the mean values of serum HBP were significantly increased in the severe sepsis group (75.67±11.85 ng/ml) and in the septic shock group (92.23 ± 16.13 ng/ml) compared with patients in the sepsis group (23.20 ± 5.26 ng/ml) (P < 0.001). Conclusion The increase in serum levels of HBP in patients with sepsis is an early predictor and diagnostic marker for the development of circulatory failure compared with the other investigated biomarkers.


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