Naslov
Low plasma concentration of endocannabinoid 2- arachidonoylglycerol increases the risk for invasive mechanical ventilation requirement in septic patients

Autori
Šahinović, Ines ; Mandić, Sanja ; Majić, Zlatko ; Perić, Ljiljana ; Šerić, Vatroslav

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
IFCC virtual conference on Critical role of clinical laboratories in the COVID-19 pandemic, 2021 / - , 2021, 121-121

Skup
IFCC Virtual Conference on Critical Role of Clinical Laboratories in the Covid-19 Pandemic

Mjesto i datum
Online, 15.02.2021. - 17.02.2021

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Endocannabinoids, 2-arachidonoylglycerol, mechanical ventilation, sepsis

Sažetak
INTRODUCTION: Mechanical ventilation (MV) is the foremost frequent life support measure used in critically ill septic patients. Patients with sepsis caused by pneumonia are in greater risk of acute respiratory distress syndrome development, in which the lungs are injured by circulating inflammatory mediators. These patients often require invasive MV due to severely impaired gas exchange. Studies have described important anti- inflammatory and protective role of the endocannabinoid system in sepsis and airway hyperreactivity. The aim of this study was to determine whether at admission point the two main endocannabinoids, anandamide and 2- arachidonoylglycerol (2-AG), can identify pneumonia-related septic patients requiring invasive MV. SUBJECTS AND METHODS: A prospective study was conducted in the Intensive Care Unit and Clinic of Infective Diseases at the University Hospital Osijek, Croatia. A total of 54 patients aged >18 years with sepsis caused by pneumonia were included in this study. 10 subjects with a matched age and comorbidity were enrolled as control group. Septic patients were divided into two groups: the group that required invasive MV during hospitalization (MV group, N=15), and the group that did not require invasive MV (non-MV group, N=39). Blood samples were collected upon admission to the hospital and serum C-reactive protein (CRP) and EDTA-plasma endocannabinoids anandamide and 2- AG were tested. The diagnostic ability of markers to predict the need for MV was assessed by the receiver operating characteristics (ROC) curve. The Youden Index was used to determine the optimal cut-off value for discrimination between MV and non-MV group. Using determined cut-off values the relative risk for MV requirement was calculated. RESULTS: Endocannabinoids anandamide and 2-AG were significantly decreased in the MV group compared to the control group (8.40 [5.93 – 9.57] μg/L vs. 12.36 [10.81 – 37.00] μg/L, P=0.004 and 5.45 [3.01 – 9.18] μg/L vs. 21.20 [15.20 – 91.71] μg/L, P=0.007, respectively). There was no significant difference between anandamide concentration in the MV and non-MV group. The median concentration of 2-AG in the MV group on the day of admission was significantly lower than in the non-MV group (5.45 [3.01 – 9.18] μg/L vs. 11.8 [7.06 – 36.55] μg/L, P=0.005). CRP was significantly increased in the MV group when compared to the non-MV group (312.9 [229.3 – 352.0] mg/L vs. 209.3 [158.2 – 278.4] mg/L, P=0.031). AUC values for 2-AG and CRP were 0.748 (95%CI 0.611 – 0.856) and 0.691 (95% CI 0.551 – 0.810), respectively. 2-AG level showed a higher relative risk for MV than the inflammatory marker CRP. A decrease of 2-AG concentration below the cut-off value 6.6 μg/L was associated with a relative risk for MV requirement of 4.35 (95% CI 1.76 – 10.78), compared to relative risk of 3.60 (95%CI 1.62 – 8.02) for a CRP increase above the cut-off value 302.4 mg/L. CONCLUSION: Patients with sepsis caused by pneumonia have lower endocannabinoids concentrations compared to healthy subjects. Plasma concentration of endocannabinoid 2-AG < 6.6 μg/L upon hospital admission identifies septic patients requiring invasive mechanical ventilation better than common inflammatory marker CRP.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Biotehnologija u biomedicini (prirodno područje, biomedicina i zdravstvo, biotehničko područje)

POVEZANOST RADA