Cargando…

Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study

Objective: The use of serum ammonia as a novel marker for sepsis compared to lactic acid levels in intensive care unit (ICU) patients. Design and Interventions: Single arm, prospective clinical trial to collect arterial blood samples from patients with sepsis. Serial ammonia and lactic acid levels w...

Descripción completa

Detalles Bibliográficos
Autores principales: Numan, Yazan, Jawaid, Yasir, Hirzallah, Hisham, Kusmic, Damir, Megri, Mohammad, Aqtash, Obadah, Amro, Ahmed, Mezughi, Haitem, Maher, Emmon, Raru, Yonas, Numan, Jamil, Akpanudo, Sutoidem, Khitan, Zeid, Shweihat, Yousef
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111562/
https://www.ncbi.nlm.nih.gov/pubmed/30049989
http://dx.doi.org/10.3390/jcm7080182
_version_ 1783350678466330624
author Numan, Yazan
Jawaid, Yasir
Hirzallah, Hisham
Kusmic, Damir
Megri, Mohammad
Aqtash, Obadah
Amro, Ahmed
Mezughi, Haitem
Maher, Emmon
Raru, Yonas
Numan, Jamil
Akpanudo, Sutoidem
Khitan, Zeid
Shweihat, Yousef
author_facet Numan, Yazan
Jawaid, Yasir
Hirzallah, Hisham
Kusmic, Damir
Megri, Mohammad
Aqtash, Obadah
Amro, Ahmed
Mezughi, Haitem
Maher, Emmon
Raru, Yonas
Numan, Jamil
Akpanudo, Sutoidem
Khitan, Zeid
Shweihat, Yousef
author_sort Numan, Yazan
collection PubMed
description Objective: The use of serum ammonia as a novel marker for sepsis compared to lactic acid levels in intensive care unit (ICU) patients. Design and Interventions: Single arm, prospective clinical trial to collect arterial blood samples from patients with sepsis. Serial ammonia and lactic acid levels were sent every six hours for a total of three days. Measurements and results: Compare mean levels of ammonia and lactic acid in terms of diagnosing sepsis and patient outcome, including length of stay and mortality. A total of 30 patients were enrolled in the pilot study. On admission, mean ammonia level was 35.7 μmol/L and lactic acid was 3.06 mmole/L. Ammonia levels checked at the end of day 2 (ammonia 2-4) and the beginning of day 3 (ammonia 3-1) were higher in patients who had a microbial culture-proven sepsis (p-values 0.029 and 0.002, respectively) compared to those without culture-positive sepsis. Ammonia levels did predict a longer hospital stay; ammonia level of more than 40 μmol/L had a mean hospital stay of 17.6 days vs. patients with normal levels who had a mean hospital stay of 9.62 days (p-value 0.0082). Conclusion: Elevated ammonia level can be a novel biomarker for sepsis, comparable to conventional markers. Ammonia levels have a prognostic utility as elevated levels were associated with longer hospital stay.
format Online
Article
Text
id pubmed-6111562
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-61115622018-08-28 Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study Numan, Yazan Jawaid, Yasir Hirzallah, Hisham Kusmic, Damir Megri, Mohammad Aqtash, Obadah Amro, Ahmed Mezughi, Haitem Maher, Emmon Raru, Yonas Numan, Jamil Akpanudo, Sutoidem Khitan, Zeid Shweihat, Yousef J Clin Med Article Objective: The use of serum ammonia as a novel marker for sepsis compared to lactic acid levels in intensive care unit (ICU) patients. Design and Interventions: Single arm, prospective clinical trial to collect arterial blood samples from patients with sepsis. Serial ammonia and lactic acid levels were sent every six hours for a total of three days. Measurements and results: Compare mean levels of ammonia and lactic acid in terms of diagnosing sepsis and patient outcome, including length of stay and mortality. A total of 30 patients were enrolled in the pilot study. On admission, mean ammonia level was 35.7 μmol/L and lactic acid was 3.06 mmole/L. Ammonia levels checked at the end of day 2 (ammonia 2-4) and the beginning of day 3 (ammonia 3-1) were higher in patients who had a microbial culture-proven sepsis (p-values 0.029 and 0.002, respectively) compared to those without culture-positive sepsis. Ammonia levels did predict a longer hospital stay; ammonia level of more than 40 μmol/L had a mean hospital stay of 17.6 days vs. patients with normal levels who had a mean hospital stay of 9.62 days (p-value 0.0082). Conclusion: Elevated ammonia level can be a novel biomarker for sepsis, comparable to conventional markers. Ammonia levels have a prognostic utility as elevated levels were associated with longer hospital stay. MDPI 2018-07-26 /pmc/articles/PMC6111562/ /pubmed/30049989 http://dx.doi.org/10.3390/jcm7080182 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Numan, Yazan
Jawaid, Yasir
Hirzallah, Hisham
Kusmic, Damir
Megri, Mohammad
Aqtash, Obadah
Amro, Ahmed
Mezughi, Haitem
Maher, Emmon
Raru, Yonas
Numan, Jamil
Akpanudo, Sutoidem
Khitan, Zeid
Shweihat, Yousef
Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study
title Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study
title_full Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study
title_fullStr Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study
title_full_unstemmed Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study
title_short Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study
title_sort ammonia vs. lactic acid in predicting positivity of microbial culture in sepsis: the alps pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111562/
https://www.ncbi.nlm.nih.gov/pubmed/30049989
http://dx.doi.org/10.3390/jcm7080182
work_keys_str_mv AT numanyazan ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT jawaidyasir ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT hirzallahhisham ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT kusmicdamir ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT megrimohammad ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT aqtashobadah ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT amroahmed ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT mezughihaitem ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT maheremmon ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT raruyonas ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT numanjamil ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT akpanudosutoidem ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT khitanzeid ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy
AT shweihatyousef ammoniavslacticacidinpredictingpositivityofmicrobialcultureinsepsisthealpspilotstudy