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Critical Care
Published in: Critical Care 1/2016

Open Access 01-12-2016 | Research

Mid-regional pro-adrenomedullin (MR-proADM), a marker of positive fluid balance in critically ill patients: results of the ENVOL study

Authors: Bernard Vigué, Pierre-Etienne Leblanc, Frédérique Moati, Eric Pussard, Hussam Foufa, Aurore Rodrigues, Samy Figueiredo, Anatole Harrois, Jean-Xavier Mazoit, Homa Rafi, Jacques Duranteau

Published in: Critical Care | Issue 1/2016

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Abstract

Background

The optimal control of blood volume without fluid overload is a main challenge in the daily care of intensive care unit (ICU) patients. Accordingly this study focused on the identification of biomarkers to help characterize fluid overload status.

Methods

Sixty-seven patients were studied from ICU admission to day 7 (D7). Blood and urine samples were taken daily and sodium and water balance strictly calculated resulting in a total cumulative assessment of ∆Na+ and ∆H2O. Furthermore, plasmatic biomarkers (cortisol, epinephrine, norepinephrine, renin, angiotensin II, aldosterone, pro-endothelin, copeptine, atrial natriuretic peptide, erythropoietin, mid-regional pro-adrenomedullin (MR-proADM)) and Sequential Organ Failure Assessment (SOFA) scores were measured at D2, D5 and D7. Blood volumes were measured with 51Cr fixed on red blood cells at D2 and D7.

Results

The ∆Na+ or ∆H2O were increased in all patients but never related to blood volumes at D2 nor D7. Total blood volumes were at normal values with constantly low red blood cell volumes and normal or decreased plasmatic volume. Weight, plasmatic proteins, and hemoglobin were weakly related to ∆Na+ or ∆H2O. Amongst all tested biomarkers, only MR-proADM was related to sodium and fluid overload. This biomarker was also a predictor of SOFA scores.

Conclusions

Plasmatic concentration in MR-proADM seems to be a good surrogate for evaluation of ∆Na+ or ∆H2O and predicts sodium and extracellular fluid overload.

Trial registration

ClinicalTrials.gov: NCT01858675 in May 13, 2013.
Appendix
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Metadata
Title
Mid-regional pro-adrenomedullin (MR-proADM), a marker of positive fluid balance in critically ill patients: results of the ENVOL study
Authors
Bernard Vigué
Pierre-Etienne Leblanc
Frédérique Moati
Eric Pussard
Hussam Foufa
Aurore Rodrigues
Samy Figueiredo
Anatole Harrois
Jean-Xavier Mazoit
Homa Rafi
Jacques Duranteau
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2016
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-016-1540-x

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