The vasopressin and copeptin response to infection, severe sepsis, and septic shock

Critical Care Medicine
Stefan JochbergerMartin W Dünser

Abstract

To compare the course of arginine vasopressin (AVP) and copeptin plasma concentrations between patients with infection, severe sepsis, and septic shock. Prospective, closed-cohort study. Twelve-bed general and surgical intensive care unit and 33-bed internal medicine ward in a university hospital. Ten patients with infection, 22 with severe sepsis, and 28 with septic shock. None. Hemodynamic, laboratory and clinical data were recorded daily during the first 7 days after intensive care unit or hospital admission. Parallel thereto, blood was withdrawn to determine plasma AVP (radioimmunoassay) and copeptin (immunoluminometric assay) concentrations. Standard tests, a mixed effects model, and a linear regression analysis were used for statistical analysis. The AVP response was different between the three study groups (p < 0.001) but did not change over time (p = 0.12). Although patients with severe sepsis and septic shock had higher AVP levels than did patients with infection (both p < 0.001), no difference in AVP concentrations was seen between severe sepsis and septic shock patients (p = 0.98). No difference in AVP was observed between survivors and nonsurvivors at day 28 (p = 0.87). In patients with severe sepsis, serum osmolari...Continue Reading

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