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Copeptin and Arginine Vasopressin Concentrations in Critically Ill Patients

  • Jochberger, Stefan Department of Anesthesiology (S.J., V.D.M., G.L., V.W., B.E.F.), A-6020 Innsbruck, Austria
  • Morgenthaler, Nils G. Department of Research (N.G.M.), B.R.A.H.M.S. Aktiengesellschaft D-16761, Hennigsdorf, Germany
  • Mayr, Viktoria D. Department of Anesthesiology (S.J., V.D.M., G.L., V.W., B.E.F.), A-6020 Innsbruck, Austria
  • Luckner, Günter Department of Anesthesiology (S.J., V.D.M., G.L., V.W., B.E.F.), A-6020 Innsbruck, Austria
  • Wenzel, Volker Department of Anesthesiology (S.J., V.D.M., G.L., V.W., B.E.F.), A-6020 Innsbruck, Austria
  • Ulmer, Hanno Institute of Medical Biostatistics (H.U.), A-6020 Innsbruck, Austria
  • Schwarz, Siegfried Division of Experimental Pathophysiology and Immunology, Biocenter (S.S.), Innsbruck Medical University, A-6020 Innsbruck, Austria
  • Hasibeder, Walter R. Department of Anesthesiology and Critical Care Medicine (W.R.H.), Krankenhaus der Barmherzigen Schwestern, A-4910 Ried im Innkreis, Austria
  • Friesenecker, Barbara E. Department of Anesthesiology (S.J., V.D.M., G.L., V.W., B.E.F.), A-6020 Innsbruck, Austria
  • Dünser, Martin W. Department of Intensive Care Medicine (M.W.D.), University Hospital of Bern, CH-3010 Bern, Switzerland
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Published in:
  • The Journal of Clinical Endocrinology & Metabolism. - The Endocrine Society. - 2006, vol. 91, no. 11, p. 4381-4386
Clinical Biochemistry
Biochemistry
Endocrinology, Diabetes and Metabolism
Endocrinology
Biochemistry, medical
English Abstract
Context: Determination of arginine vasopressin (AVP) concentrations may be helpful to guide therapy in critically ill patients. A new assay analyzing copeptin, a stable peptide derived from the AVP precursor, has been introduced.
Objective: Our objective was to determine plasma copeptin concentrations.
Design: We conducted a post hoc analysis of plasma samples and data from a prospective study.
Setting: The setting was a 12-bed general and surgical intensive care unit (ICU) in a tertiary university teaching hospital.
Patients: Our subjects were 70 healthy volunteers and 157 ICU patients with sepsis, with systemic inflammatory response syndrome (SIRS), and after cardiac surgery.
Interventions: There were no interventions.
Main Outcome Measures: Copeptin plasma concentrations, demographic data, AVP plasma concentrations, and a multiple organ dysfunction syndrome score were documented 24 h after ICU admission.
Results: AVP (P < 0.001) and copeptin (P < 0.001) concentrations were significantly higher in ICU patients than in controls. Patients after cardiac surgery had higher AVP (P = 0.003) and copeptin (P = 0.003) concentrations than patients with sepsis or SIRS. Independent of critical illness, copeptin and AVP correlated highly significantly with each other. Critically ill patients with sepsis and SIRS exhibited a significantly higher ratio of copeptin/AVP plasma concentrations than patients after cardiac surgery (P = 0.012). The American Society of Anesthesiologists’ classification (P = 0.046) and C-reactive protein concentrations (P = 0.006) were significantly correlated with the copeptin/AVP ratio.
Conclusions: Plasma concentrations of copeptin and AVP in healthy volunteers and critically ill patients correlate significantly with each other. The ratio of copeptin/AVP plasma concentrations is increased in patients with sepsis and SIRS, suggesting that copeptin may overestimate AVP plasma concentrations in these patients.
Language
  • English
Open access status
green
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Persistent URL
https://folia.unifr.ch/global/documents/89843
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