INTRODUCTION Comparison of the marker kinetics procalcitonin, presepsin, and endotoxin during extracorporeal hemoperfusion with polymyxin-B adsorbing cartridge (PMX-HA) has never been described in abdominal sepsis. We aimed to compare the trend of three biomarkers in septic post-surgical abdominal patients in intensive care unit (ICU) treated with PMX-HA and their prognostic value. METHODS Ninety abdominal post-surgical patients were enrolled into different groups according to the evidence of postoperative sepsis or not. Non-septic patients admitted in the surgical ward were included in C group (control group). ICU septic shock patients with endotoxin levels <0.6 EAA receiving conventional therapy were addressed in S group and those with endotoxin levels ≥0.6 EAA receiving treatment with PMX-HA, besides conventional therapy, were included in SPB group. Presepsin, procalcitonin, endotoxin and other clinical data were recorded at 24 h (T0), 72 h (T1) and 7 days (T2) after surgery. Clinical follow-up was performed on day 30. RESULTS SPB group showed reduced levels of the three biomarkers on T2 versus T0 (p < 0.001); presepsin, procalcitonin and endotoxin levels decreased, respectively, by 25%, 11%, and 2% on T1 versus T0, and 40%, 41%, and 26% on T2 versus T0. All patients in C group, 73% of patients in SPB group versus 37% of patients in S group survived at follow-up. Moreover, procalcitonin had the highest predictive value for mortality at 30 days, followed by presepsin. CONCLUSION The present study showed the reliability of presepsin in monitoring PMX-HA treatment in septic shock patients. Procalcitonin showed better predicting power for the mortality riSsk.

中文翻译：

---

腹部脓毒症多粘菌素 B 体外血液灌流过程中不同血液生物标志物的动力学。


引言 从未在腹部脓毒症中使用多粘菌素 B 吸附盒 (PMX-HA) 进行体外血液灌流期间对降钙素原、前蛋白酶和内毒素的标志物动力学比较进行描述。我们的目的是比较重症监护室 (ICU) 接受 PMX-HA 治疗的脓毒症腹部手术后患者的三种生物标志物的趋势及其预后价值。方法将90例腹部术后患者根据术后是否发生脓毒症分为不同组。手术病房收治的非脓毒症患者纳入C组（对照组）。内毒素水平<0.6 EAA的ICU脓毒性休克患者接受常规治疗纳入S组，内毒素水平≥0.6 EAA的患者在常规治疗基础上接受PMX-HA治疗纳入SPB组。记录术后24 h（T0）、72 h（T1）、7 d（T2）的Presepsin、降钙素原、内毒素等临床数据。第 30 天进行临床随访。结果 SPB 组显示 T2 与 T0 时三种生物标志物的水平降低（p < 0.001）；与 T0 相比，T1 上的前蛋白酶、降钙素原和内毒素水平分别降低了 25%、11% 和 2%，T2 上与 T0 相比分别降低了 40%、41% 和 26%。随访时，C 组的所有患者、SPB 组的患者为 73%，S 组的患者为 37%。此外，降钙素原对 30 天死亡率的预测价值最高，其次是 presepsin。结论 本研究表明 presepsin 在监测感染性休克患者 PMX-HA 治疗方面的可靠性。降钙素原对死亡风险显示出更好的预测能力。