Searching for predictors of surgical complications in critically ill surgery patients in the intensive care unit: a review.

We reviewed the use of the levels of C-reactive protein, lactate and procalcitonin and/or the Sequential Organ Failure Assessment score to determine their diagnostic accuracy for predicting surgical complications in critically ill general post-surgery patients. Included were all studies published in PubMed from inception to July 2013 that met the following inclusion criteria: evaluation of the above parameters, describing their diagnostic accuracy and the risk stratification for surgical complications in surgical patients admitted to an intensive care unit. No difference in the Sequential Organ Failure Assessment scores was seen between patients with or without complications.

Procalcitonin in the recognition of complications in critically ill surgical patients.

Background: Procalcitonin (PCT) is a relatively new, promising indirect parameter for infection. In the intensive care unit (ICU) it can be used as a marker for sepsis. However, in the ICU there is a need for reliable markers for clinical deterioration in the critically ill patients.

Determining the clinical value of lactate in surgical patients on the intensive care unit.

Background: The purpose of this study is first to assess the clinical value of lactate concentrations by comparison with clinical scoring systems, and second to determine the value of lactate levels in clinical decisions as ordering diagnostic and therapeutic (re)interventions in the population of critically ill surgical patients on the intensive care unit (ICU).

Materials And Methods: From April 2010 to June 2011, the L-lactate concentrations, Sequential Organ Failure Assessment (SOFA) score and Acute Physiological and Chronic Health Evaluation II (APACHE II) score were prospectively collected in surgical patients (n = 174) admitted into the ICU. The L-Lactate and scoring systems were related to events defined as performing computed tomography-scans, laparotomy, ultrasonography, and flexible endoscopy.

The role of C-reactive protein and the SOFA score as parameter for clinical decision making in surgical patients during the intensive care unit course.

Introduction: C-reactive Protein (CRP) is used next to clinical scoring systems to recognize critically ill patients prone to develop complications on the Intensive Care Unit (ICU). The purpose of this study is to assess the predictive value of CRP as parameter for clinical deterioration and/or clinical decision making as ordering diagnostic procedures or performing (re)interventions. Also, we wanted to determine the value of CRP in early detection of surgical complications in the critically ill general surgical patient in the ICU and its interpretation in adjunct to a clinical scoring system, the Sequential Organ Failure Assessment Score.

The value of C-reactive protein and lactate in the acute abdomen in the emergency department.

Case Presentation: This report describes the presentation of three critically ill patients with non-traumatic acute abdominal pain and increased concentrations of the biomarkers C-reactive protein (CRP) and lactate. In these three patients an exploratory laparotomy was carried out. Remarkably, the laparotomy showed no intra-abdominal abnormalities.

A positive family history for premature cardiovascular disease identifies patients prone to recurrent arterial thrombotic events.

Background: Cardiovascular disease (CVD) is characterized by slow progressive atherosclerosis and arterial thrombotic events, leading to occlusions. Whether either of these presentations is more likely in patients with a genetic predisposition for CVD is still unknown. We suggest that a genetic predisposition for CVD is related to recurrent events of the same nature.

Patients with premature cardiovascular disease and a positive family history for cardiovascular disease are prone to recurrent events.

Background: Premature cardiovascular disease (CVD) is treated in the same way as CVD of advanced age. However, in patients with premature CVD and a family history of CVD, different -possibly genetic- mechanisms may underlie this disease, which current medical treatment is not targeted to. This suggests that subjects with a genetic predisposition to CVD are more likely to have recurrent cardiovascular events.