Pyrexia, procalcitonin, immune activation and survival in cardiogenic shock: The potential importance of bacterial translocation

Frank M. Brunkhorst, Andrew L. Clark, Zdziflaw F. Forycki, Stefan D. Anker

Research output: Contribution to journalArticle

Abstract

Aims: Exposure to bacterial endotoxin, perhaps due to bowel congestion or ischaemia and altered gut permeability, may result in immune activation that is characteristic for patients with severe heart failure. It is known that blood procalcitonin rises in response to bacterial endotoxin exposure. Methods: We measured procalcitonin in a group of 29 patients with acute cardiogenic shock and no sign of infection (all without bacteraemia) and 26 with septic shock. Blood was analysed for procalcitonin, interleukin-6, tumour necrosis factor-α (TNF-α), c-reactive protein (CRP) and neopterin. Patients were managed conventionally in an intensive care unit with no further experimental procedures. Results: Three cardiogenic (10%) and seven septic shock patients (27%) survived. Most patients with acute heart failure surviving 12 h or more (18 of 20) developed a pyrexia (738.0°C) of unknown origin in the absence of positive cultures, with a rise in procalcitonin (1.4±0.8 to 48.0±16.2 ng/ml, P

Original languageEnglish
Pages (from-to)3-10
Number of pages8
JournalInternational Journal of Cardiology
Volume72
Issue number1
DOIs
Publication statusPublished - Dec 15 1999

Keywords

  • Acute heart failure
  • Bacterial endotoxin
  • Cardiogenic shock
  • Cytokines
  • Procalcitonin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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