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Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children

Low copeptin levels may indicate inadequate arginine-vasopressin release promoting arterial hypotension, whereas high copeptin concentrations may reflect disease severity. This single-center prospective non-randomized clinical trial analyzed the course of blood copeptin in critically ill normo- and...

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Autores principales: Baumann, Philipp, Gotta, Verena, Atkinson, Andrew, Deisenberg, Markus, Hersberger, Martin, Roggia, Adam, Schmid, Kevin, Cannizzaro, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9222164/
https://www.ncbi.nlm.nih.gov/pubmed/35740731
http://dx.doi.org/10.3390/children9060794
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author Baumann, Philipp
Gotta, Verena
Atkinson, Andrew
Deisenberg, Markus
Hersberger, Martin
Roggia, Adam
Schmid, Kevin
Cannizzaro, Vincenzo
author_facet Baumann, Philipp
Gotta, Verena
Atkinson, Andrew
Deisenberg, Markus
Hersberger, Martin
Roggia, Adam
Schmid, Kevin
Cannizzaro, Vincenzo
author_sort Baumann, Philipp
collection PubMed
description Low copeptin levels may indicate inadequate arginine-vasopressin release promoting arterial hypotension, whereas high copeptin concentrations may reflect disease severity. This single-center prospective non-randomized clinical trial analyzed the course of blood copeptin in critically ill normo- and hypotensive children and its association with disease severity. In 164 patients (median age 0.5 years (interquartile range 0.1, 2.9)), the mean copeptin concentration at baseline was 43.5 pmol/L. Though not significantly different after 61 h (primary outcome, mean individual change: −12%, p = 0.36, paired t-test), we detected 1.47-fold higher copeptin concentrations during arterial hypotension when compared to normotension (mixed-effect ANOVA, p = 0.01). In total, 8 out of 34 patients (23.5%) with low copeptin concentrations <10 pmol/L were hypotensive. Copeptin was highest in the adjusted mixed-effect regression analysis within the first day (+20% at 14 h) and decreased significantly at 108 h (−27%) compared to baseline (p = 0.002). Moreover, we found a significant association with vasopressor-inotrope treatment intensity, infancy (1–12 months) and cardiopulmonary bypass (all p ≤ 0.001). In conclusion, high copeptin values were associated with arterial hypotension and severity of disease in critically ill children. This study does not support the hypothesis that low copeptin values might be indicative of arginine-vasopressin deficiency.
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spelling pubmed-92221642022-06-24 Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children Baumann, Philipp Gotta, Verena Atkinson, Andrew Deisenberg, Markus Hersberger, Martin Roggia, Adam Schmid, Kevin Cannizzaro, Vincenzo Children (Basel) Article Low copeptin levels may indicate inadequate arginine-vasopressin release promoting arterial hypotension, whereas high copeptin concentrations may reflect disease severity. This single-center prospective non-randomized clinical trial analyzed the course of blood copeptin in critically ill normo- and hypotensive children and its association with disease severity. In 164 patients (median age 0.5 years (interquartile range 0.1, 2.9)), the mean copeptin concentration at baseline was 43.5 pmol/L. Though not significantly different after 61 h (primary outcome, mean individual change: −12%, p = 0.36, paired t-test), we detected 1.47-fold higher copeptin concentrations during arterial hypotension when compared to normotension (mixed-effect ANOVA, p = 0.01). In total, 8 out of 34 patients (23.5%) with low copeptin concentrations <10 pmol/L were hypotensive. Copeptin was highest in the adjusted mixed-effect regression analysis within the first day (+20% at 14 h) and decreased significantly at 108 h (−27%) compared to baseline (p = 0.002). Moreover, we found a significant association with vasopressor-inotrope treatment intensity, infancy (1–12 months) and cardiopulmonary bypass (all p ≤ 0.001). In conclusion, high copeptin values were associated with arterial hypotension and severity of disease in critically ill children. This study does not support the hypothesis that low copeptin values might be indicative of arginine-vasopressin deficiency. MDPI 2022-05-28 /pmc/articles/PMC9222164/ /pubmed/35740731 http://dx.doi.org/10.3390/children9060794 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Baumann, Philipp
Gotta, Verena
Atkinson, Andrew
Deisenberg, Markus
Hersberger, Martin
Roggia, Adam
Schmid, Kevin
Cannizzaro, Vincenzo
Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children
title Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children
title_full Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children
title_fullStr Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children
title_full_unstemmed Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children
title_short Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children
title_sort copeptin release in arterial hypotension and its association with severity of disease in critically ill children
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9222164/
https://www.ncbi.nlm.nih.gov/pubmed/35740731
http://dx.doi.org/10.3390/children9060794
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