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PSP is a promising biomarker of sepsis; however, potential elimination by RRT must be considered

Critical Care volume 26, Article number: 342 (2022) Cite this article

The Original Article was published on 08 April 2022

According to Lopez et al. pancreatic stone protein (PSP) is “a promising biomarker to diagnose infections in hospitalized patients,” distinguishing infections from non-infections and outperforming C-reactive protein (CRP) and procalcitonin (PCT) [1]. PSP is a 16 kDa C-type lectin protein [1]. In patients admitted for sepsis, the value of PSP at admission correlates with the Sequential Organ Failure Assessment (SOFA) score and can predict intensive care unit (ICU) mortality [1]. Lopez et al. based most of their findings on a study looking at 90 severe patients in a burn ICU [2]. Septic shock induced acute kidney injury (AKI) in at least 50% and 25% needed continuous renal replacement therapy (CRRT) [3]. However, looking at the molecular weight of PSP, we do need to consider potential elimination by RRT using membranes with a cut off of 35–40 kDa [4]. New highly adsorptive membranes (HAM) could also absorb PSP in addition to the removal by convection [5]. Since the risk of elimination by CRRT is very likely, PSP is potentially unreliable for predicting either septic shock or patients needing to be transferred to the ICU. Before analyzing the accuracy of PSP studies are needed to determine if PSP is significantly eliminated or not by CRRT.

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Abbreviations

PSP:

Pancreatic stone protein

CRP:

C reactive protein

PCT:

Procalcitonin

SOFA:

Sequential organ failure assessment

ICU:

Intensive care unit

AKI:

Acute kidney injury

CRRT:

Continuous renal replacement therapy

HAM:

High adsorptive membranes

References

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Authors and Affiliations

  1. ICU Department, Centre Hospitalier Universitaire Brugmann, Brugmann University Hospital, Place Van Gehuchtenplein, 4, 1020, Brussels, Belgium

    Patrick M. Honore, Sebastien Redant, Pharan Djimafo, Keitiane Kaefer, Leonel Barreto Gutierrez, Sami Anane, Andrea Gallerani & Rachid Attou

  2. Centre Hospitalier Universitaire Brugmann, ULB University, Brussels, Belgium

    Sydney Blackman, Ibrahim Bousbiat & Emily Perriens

  3. ED Department, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium

    Thierry Preseau & Bogdan Vasile Cismas

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  1. Patrick M. Honore
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  2. Sebastien Redant
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  3. Pharan Djimafo
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  4. Sydney Blackman
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  5. Ibrahim Bousbiat
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  6. Emily Perriens
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  7. Thierry Preseau
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  12. Andrea Gallerani
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  13. Rachid Attou
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Contributions

PMH, RA designed the paper. PMH, SR, PD, SB, IB, EP, TP, BVC, KK, LBG, SA, AG, RA participated in drafting and reviewing. PMH, SR, PD, SB, IB, EP, TP, BVC, KK, LBG, SA, AG, RA read and approved the final version of the manuscript.

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Correspondence to Patrick M. Honore.

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Honore, P.M., Redant, S., Djimafo, P. et al. PSP is a promising biomarker of sepsis; however, potential elimination by RRT must be considered. Crit Care 26, 342 (2022). https://doi.org/10.1186/s13054-022-04214-7

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Critical Care

ISSN: 1364-8535