Journal of Critical Care
Volume 26, Issue 3 , Pages 330.e9-330.e12 , June 2011

Protein C as an early biomarker to distinguish pneumonia from sepsis

  • Scott Gutovitz, MD

      Affiliations

    • Department of Emergency Medicine, University of Kansas Hospital, Kansas City, KS 66160
    • Corresponding Author InformationCorresponding author. Department of Emergency Medicine, 3901 Rainbow Blvd, University of Kansas Hospital, Kansas City, KS 66160, USA.
  • ,
  • Linda Papa, MD

      Affiliations

    • Department of Emergency Medicine, Orlando Health, Orlando, FL 32806
  • ,
  • Edgar Jimenez, MD

      Affiliations

    • Department of Emergency Medicine, Orlando Health, Orlando, FL 32806
  • ,
  • Jay Falk, MD

      Affiliations

    • Department of Emergency Medicine, Orlando Health, Orlando, FL 32806
  • ,
  • Leighann Wieman, MD

      Affiliations

    • Department of Emergency Medicine, Orlando Health, Orlando, FL 32806
  • ,
  • Sandra Sawyer, BA

      Affiliations

    • Department of Emergency Medicine, Orlando Health, Orlando, FL 32806
  • ,
  • Philip Giordano, MD

      Affiliations

    • Department of Emergency Medicine, Orlando Health, Orlando, FL 32806

References 

  1. Angus DC, Linde-Zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303–1310
  2. Dellinger RP, Levy MM, Carlet JM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock. Crit Care Med. 2008;36:296–327
  3. Nguyen HB, Rivers EP, Abrahamian FM, et al. Severe sepsis and septic shock: review of the literature and emergency department management guidelines. Ann Emerg Med. 2006;48:28–54
  4. Nguyen HB, Corbett SW, Steele R, et al. Implementation of a bundle of quality indicators for the early management of severe sepsis and septic shock is associated with decreased mortality. Crit Care Med. 2007;35:1105–1112
  5. Shapiro NI, Howell M, Talmor D, et al. Implementation and outcomes of the multiple urgent sepsis therapies (MUST) protocol. Crit Care Med. 2006;34:1025–1032
  6. Strand K, Flatten H. Severity scoring in the ICU: a review. Acta Anaesthesiol Scand. 2008;52:467–478
  7. Rhee K, Fisher C, Willitis N. The Rapid Acute Physiology Score. Am J Emerg Med. 1987;5:278–286
  8. Olsson T, Terent A, Lind L. Rapid emergency medicine score: a new prognostic tool for in-hospital mortality in nonsurgical emergency department patients. J Intern Med. 2004;255:579–587
  9. Howell MD, Donnino MW, Talmor D, et al. Performance of severity of illness scoring systems in emergency department patients with infection. Acad Emerg Med. 2007;14:709–714
  10. Shapiro NI, Wolfe RE, Moore RB, et al. Mortality in emergency department sepsis (MEDS) score: a prospectively derived and validated clinical prediction rule. Crit Care Med. 2003;31:670–675
  11. Rivers EP, Kruse JA, Jacobsen G, et al. The influence of early hemodynamic optimization on biomarker patterns of severe sepsis and septic shock. Crit Care Med. 2007;35:2016–2024
  12. Esmon CT, Taylor FB, Snow TR. Inflammation and coagulation: linked processes potentially regulated through a common pathway mediated by protein C. Thromb Haemost. 1991;66:160–165
  13. Esmon CT. The protein C anticoagulant pathway. Arterioscler Thromb. 1992;12:135–145
  14. Boehme MW, Deng Y, Raeth U, et al. Release of thrombomodulin from endothelial cells by concerted action of TNF-alpha and neurophils: in vivo and in vitro studies. Immunology. 1996;87:134–140
  15. Mesters RM, Mannucci PM, Coppola R, et al. Factor VIIa and antithrombin III activity during severe sepsis and septic shock in neutropenic patients. Blood. 1996;88:881–886
  16. Liaw PCY, Esmon CT, Kahnamoui K, et al. Patients with severe sepsis vary markedly in their ability to generate activated protein C. Blood. 2004;104:3958–3964
  17. Kurosawa S, Stearns-Kurosawa DJ, Carson CW, et al. Plasma levels of endothelial cell protein C receptor are elevated in patients with sepsis and systemic lupus erythematosus: lack of correlation with thrombomodulin suggests involvement of different pathological processes. Blood. 1998;91:725–727
  18. Fisher CJ, Yan SB. Protein C levels as a prognostic indicator of outcome in sepsis and related diseases. Crit Care Med. 2000;28:S49–S56
  19. Dremsizov T, Clermont G, Kellum JA, et al. Severe sepsis in community-acquired pneumonia: when does it happen, and do systemic inflammatory response syndrome criteria help predict course?. Chest. 2006;129:968–978
  20. Aujesky D, Auble TE, Yealy DM, et al. Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia. Am J Med. 2005;118:384–392
  21. Johnstone J, Majumdar SR, Marrie TJ. The value of prognostic indices for pneumonia. Curr Infect Dis Rep. 2008;10:215–222
  22. Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997;336(4):243–250

 Conflicts of interest: None of the listed authors have any personal or financial conflicts of interest to disclose in this study.

PII: S0883-9441(10)00178-4

doi: 10.1016/j.jcrc.2010.07.002

Journal of Critical Care
Volume 26, Issue 3 , Pages 330.e9-330.e12 , June 2011