Biomarkers of necrotising soft tissue infections: aspects of the innate immune response and effects of hyperbaric oxygenation-the protocol of the prospective cohort BIONEC study

Marco Bo Hansen; Ulf Simonsen; Peter Garred; Ole Hyldegaard

doi:10.1136/bmjopen-2014-006995

Biomarkers of necrotising soft tissue infections: aspects of the innate immune response and effects of hyperbaric oxygenation-the protocol of the prospective cohort BIONEC study

Marco Bo Hansen, Ulf Simonsen, Peter Garred, Ole Hyldegaard

Department of Clinical Medicine

8 Citations (Scopus)

Abstract

Introduction: The mortality and amputation rates are still high in patients with necrotising soft tissue infections (NSTIs). It would be ideal to have a set of biomarkers that enables the clinician to identify highrisk patients with NSTI on admission. The objectives of this study are to evaluate inflammatory and vasoactive biomarkers as prognostic markers of severity and mortality in patients with NSTI and to investigate whether hyperbaric oxygen treatment (HBOT) is able to modulate these biomarkers. The overall hypothesis is that plasma biomarkers can be used as prognostic markers of severity and mortality in patients with NSTI and that HBOT reduces the inflammatory response. Methods and analysis: This is a prospective, observational study being conducted in a tertiary referral centre. Biomarkers will be measured in 114 patients who have been operatively diagnosed with NSTI. On admission, baseline blood values will be obtained. Following surgery and HBOT, daily blood samples for measuring regular inflammatory and vasoactive biomarkers ( pentraxin-3, interleukin-6 and nitrite) will be acquired. Samples will be analysed using validated ELISA assays, chemiluminescence and Griess reaction. Clinical data will be obtained during admission in the intensive care unit for a maximum of 7 days. The primary analysis will focus on pentraxin-3, interleukin-6 and nitrite as early markers of disease severity in patients with NSTI. Ethics and dissemination: The study has been approved by the Regional Scientific Ethical Committee of Copenhagen (H-2-2014-071) and the Danish Data Protection Agency ( J. no. 30-0900 and J. no. 30-1282). Results will be presented at national and international conferences and published in peer-reviewed scientific journals.

Original language	English
Article number	e006995
Journal	B M J Open
Volume	5
Issue number	5
Pages (from-to)	1-9
Number of pages	9
ISSN	2044-6055
DOIs	https://doi.org/10.1136/bmjopen-2014-006995
Publication status	Published - 2015

Keywords

Biomarkers
C-Reactive Protein
Critical Care
Fasciitis, Necrotizing
Female
Humans
Hyperbaric Oxygenation
Immunity, Innate
Interleukin-6
Length of Stay
Male
Nitrites
Prognosis
Prospective Studies
Serum Amyloid P-Component
Soft Tissue Infections
Treatment Outcome

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Biomarkers of necrotising soft tissue infections: aspects of the innate immune response and effects of hyperbaric oxygenation-the protocol of the prospective cohort BIONEC study. / Hansen, Marco Bo; Simonsen, Ulf; Garred, Peter et al.
In: B M J Open, Vol. 5, No. 5, e006995, 2015, p. 1-9.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Biomarkers of necrotising soft tissue infections: aspects of the innate immune response and effects of hyperbaric oxygenation-the protocol of the prospective cohort BIONEC study",

abstract = "Introduction: The mortality and amputation rates are still high in patients with necrotising soft tissue infections (NSTIs). It would be ideal to have a set of biomarkers that enables the clinician to identify highrisk patients with NSTI on admission. The objectives of this study are to evaluate inflammatory and vasoactive biomarkers as prognostic markers of severity and mortality in patients with NSTI and to investigate whether hyperbaric oxygen treatment (HBOT) is able to modulate these biomarkers. The overall hypothesis is that plasma biomarkers can be used as prognostic markers of severity and mortality in patients with NSTI and that HBOT reduces the inflammatory response. Methods and analysis: This is a prospective, observational study being conducted in a tertiary referral centre. Biomarkers will be measured in 114 patients who have been operatively diagnosed with NSTI. On admission, baseline blood values will be obtained. Following surgery and HBOT, daily blood samples for measuring regular inflammatory and vasoactive biomarkers ( pentraxin-3, interleukin-6 and nitrite) will be acquired. Samples will be analysed using validated ELISA assays, chemiluminescence and Griess reaction. Clinical data will be obtained during admission in the intensive care unit for a maximum of 7 days. The primary analysis will focus on pentraxin-3, interleukin-6 and nitrite as early markers of disease severity in patients with NSTI. Ethics and dissemination: The study has been approved by the Regional Scientific Ethical Committee of Copenhagen (H-2-2014-071) and the Danish Data Protection Agency ( J. no. 30-0900 and J. no. 30-1282). Results will be presented at national and international conferences and published in peer-reviewed scientific journals.",

keywords = "Biomarkers, C-Reactive Protein, Critical Care, Fasciitis, Necrotizing, Female, Humans, Hyperbaric Oxygenation, Immunity, Innate, Interleukin-6, Length of Stay, Male, Nitrites, Prognosis, Prospective Studies, Serum Amyloid P-Component, Soft Tissue Infections, Treatment Outcome",

author = "Hansen, {Marco Bo} and Ulf Simonsen and Peter Garred and Ole Hyldegaard",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.",

year = "2015",

doi = "10.1136/bmjopen-2014-006995",

language = "English",

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T1 - Biomarkers of necrotising soft tissue infections

T2 - aspects of the innate immune response and effects of hyperbaric oxygenation-the protocol of the prospective cohort BIONEC study

AU - Hansen, Marco Bo

AU - Simonsen, Ulf

AU - Garred, Peter

AU - Hyldegaard, Ole

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2015

Y1 - 2015

N2 - Introduction: The mortality and amputation rates are still high in patients with necrotising soft tissue infections (NSTIs). It would be ideal to have a set of biomarkers that enables the clinician to identify highrisk patients with NSTI on admission. The objectives of this study are to evaluate inflammatory and vasoactive biomarkers as prognostic markers of severity and mortality in patients with NSTI and to investigate whether hyperbaric oxygen treatment (HBOT) is able to modulate these biomarkers. The overall hypothesis is that plasma biomarkers can be used as prognostic markers of severity and mortality in patients with NSTI and that HBOT reduces the inflammatory response. Methods and analysis: This is a prospective, observational study being conducted in a tertiary referral centre. Biomarkers will be measured in 114 patients who have been operatively diagnosed with NSTI. On admission, baseline blood values will be obtained. Following surgery and HBOT, daily blood samples for measuring regular inflammatory and vasoactive biomarkers ( pentraxin-3, interleukin-6 and nitrite) will be acquired. Samples will be analysed using validated ELISA assays, chemiluminescence and Griess reaction. Clinical data will be obtained during admission in the intensive care unit for a maximum of 7 days. The primary analysis will focus on pentraxin-3, interleukin-6 and nitrite as early markers of disease severity in patients with NSTI. Ethics and dissemination: The study has been approved by the Regional Scientific Ethical Committee of Copenhagen (H-2-2014-071) and the Danish Data Protection Agency ( J. no. 30-0900 and J. no. 30-1282). Results will be presented at national and international conferences and published in peer-reviewed scientific journals.

AB - Introduction: The mortality and amputation rates are still high in patients with necrotising soft tissue infections (NSTIs). It would be ideal to have a set of biomarkers that enables the clinician to identify highrisk patients with NSTI on admission. The objectives of this study are to evaluate inflammatory and vasoactive biomarkers as prognostic markers of severity and mortality in patients with NSTI and to investigate whether hyperbaric oxygen treatment (HBOT) is able to modulate these biomarkers. The overall hypothesis is that plasma biomarkers can be used as prognostic markers of severity and mortality in patients with NSTI and that HBOT reduces the inflammatory response. Methods and analysis: This is a prospective, observational study being conducted in a tertiary referral centre. Biomarkers will be measured in 114 patients who have been operatively diagnosed with NSTI. On admission, baseline blood values will be obtained. Following surgery and HBOT, daily blood samples for measuring regular inflammatory and vasoactive biomarkers ( pentraxin-3, interleukin-6 and nitrite) will be acquired. Samples will be analysed using validated ELISA assays, chemiluminescence and Griess reaction. Clinical data will be obtained during admission in the intensive care unit for a maximum of 7 days. The primary analysis will focus on pentraxin-3, interleukin-6 and nitrite as early markers of disease severity in patients with NSTI. Ethics and dissemination: The study has been approved by the Regional Scientific Ethical Committee of Copenhagen (H-2-2014-071) and the Danish Data Protection Agency ( J. no. 30-0900 and J. no. 30-1282). Results will be presented at national and international conferences and published in peer-reviewed scientific journals.

KW - Biomarkers

KW - C-Reactive Protein

KW - Critical Care

KW - Fasciitis, Necrotizing

KW - Female

KW - Humans

KW - Hyperbaric Oxygenation

KW - Immunity, Innate

KW - Interleukin-6

KW - Length of Stay

KW - Male

KW - Nitrites

KW - Prognosis

KW - Prospective Studies

KW - Serum Amyloid P-Component

KW - Soft Tissue Infections

KW - Treatment Outcome

U2 - 10.1136/bmjopen-2014-006995

DO - 10.1136/bmjopen-2014-006995

M3 - Journal article

C2 - 25967993

SN - 2044-6055

VL - 5

SP - 1

EP - 9

JO - B M J Open

JF - B M J Open

IS - 5

M1 - e006995

ER -

Biomarkers of necrotising soft tissue infections: aspects of the innate immune response and effects of hyperbaric oxygenation-the protocol of the prospective cohort BIONEC study

Abstract

Keywords

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