A sustained reduction in serum cholinesterase enzyme activity predicts patient outcome following sepsis

• Verfasst von: Živković, Aleksandar [VerfasserIn]
• Verfasst von: Decker, Sebastian [VerfasserIn]
• Verfasst von: Schmidt, Karsten [VerfasserIn]
• Verfasst von: Weigand, Markus A. [VerfasserIn]
• Verfasst von: Hofer, Stefan [VerfasserIn]
• Verfasst von: Brenner, Thorsten [VerfasserIn]
• Titel: A sustained reduction in serum cholinesterase enzyme activity predicts patient outcome following sepsis
• Verf.angabe: Aleksandar R. Zivkovic, Sebastian O. Decker, Anne C. Zirnstein, Annette Sigl, Karsten Schmidt, Markus A. Weigand, Stefan Hofer, and Thorsten Brenner
• E-Jahr: 2018
• Jahr: 29 April 2018
• Umfang: 10 S.
• Fussnoten: Gesehen am 08.06.2018
• Titel Quelle: Enthalten in: Mediators of inflammation
• Ort Quelle: Sylvania, Ohio : Hindawi Publishing Corp., 1992
• Jahr Quelle: 2018
• Band/Heft Quelle: (2018) Artikel-Nummer 1942193, 10 Seiten
• ISSN Quelle: 1466-1861
• DOI: doi:10.1155/2018/1942193
• Datenträger: Online-Ressource
• Sprache: eng
• Bibliogr. Hinweis: Ergänzung: Živković, Aleksandar, 1976 - : Response to: Comment on “A sustained reduction in serum cholinesterase enzyme activity predicts patient outcome following sepsis”
• K10plus-PPN: 1576202518
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Early sepsis identification is of paramount importance for an effective therapy and the patient outcome; however, a suitable prognostic biomarker is lacking. Anti-inflammatory nonneuronal cholinergic signaling modulates the magnitude of an immune response. Serum cholinesterase (BChE), an enzyme that hydrolyzes acetylcholine, plays an important role during inflammatory response and serves as an accurate index of cholinergic activity. BChE activity was measured in septic patients using a point-of-care system, and levels of conventional inflammatory markers and the disease severity scores were obtained. We observed a strong, sustained reduction in BChE activity in patients who died within a 90-day observation period, as compared to survivors. Reduced BChE activity when measured at the ICU admission effectively differentiated between the 90-day survivor and the nonsurvivor patient groups. We estimated a critical BChE level of 1.661 kU/L (CI 0.5-0.8, 94% sensitivity, 48% specificity, AUC 0.7) to best predict patient outcome providing a benchmark criterion for early detection of potentially fatal sepsis measured at the admission. This finding suggests that the BChE activity, used in combination with the laboratory tests, clinical examination, and the disease severity scoring, could serve to identify high-risk patients at the ICU admission, the most critical time point in the sepsis treatment.