Resuscitation Failure, Oxidative Stress, and Necroptosis as Mortality Predictor in Septic Patient

Study Overview
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Brief Summary
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Resuscitation failure, oxidative stress and necroptosis were able to predict mortality in septic patient

Detailed Description
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This prospective cohort study was conducted at resuscitation room and ICU of Mohammad Hoesin hospital, a single tertiary teaching hospital in Palembang, South Sumatera. This study was started after ethical and location authorization were unleashed in February to August 2019. Inclusion criteria were patients aged 18 years old or above who met Sepsis-3 definition and diagnosed with sepsis. Exclusion criteria were patients whose family did not give any consent to participate, not treated at the ICU, had a late diagnosis (>24 h), pregnant, and diagnosed with brain dead. Drop out criteria including patients who died <4 h after diagnosed and could not be followed in 28 days. Investigators were trained to identified all eligible subjects. All the subjects had a standard resuscitation and their blood was taken to be examined at the laboratory. Subjects were observed in 28 days whether there were any mortality or not. Failed resuscitation defined by examined lactate level ≥ 2 mmol/L or lactate reduction <20%. Data was statistically analyzed with STATA™

Official Title
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Resuscitation Failure, Protein Carbonyl and Receptor Interacting Protein Kinase 3 as Mortality Predictor in Septic Patient

Conditions
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Sepsis

Intervention / Treatment
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* Diagnostic Test: Blood Collection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants aged 18 years old or above Diagnosed sepsis using Sepsis-3 definition Exclusion Criteria: Participants whose family did not give any consent to participate Not treated at the ICU Had a late diagnosis (>24 h) Pregnant Brain dead

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Resuscitation Failure, High PCO Level, High RIPK3 Level<br>Resuscitation failure was defined as lactate level ≥2 mmol/L or lactate reduction <20% hour-4 after initial sepsis recognition. High PCO level was defined as PCO level ≥ cut off point. High RIPK3 level was defined as PCO level ≥ cut off point. | Diagnostic Test: Blood Collection<br>* Blood Gas Analysis using Stat Profile pHOx® Series (nova biomedical, Waltham, U.S.) and Enzym-linked Immunosorbent Assay (ELISA) using Bio-Rad (Bio-Rad Laboratories, California, U.S.)<br>|
| Resuscitation Success, Low PCO Level, Low RIPK3 Level<br>Resuscitation success was defined as lactate level <2 mmol/L or lactate reduction ≥20% hour-4 after initial sepsis recognition. Low PCO level was defined as PCO level < cut off point. Low RIPK3 level was defined as PCO level < cut off point. | Diagnostic Test: Blood Collection<br>* Blood Gas Analysis using Stat Profile pHOx® Series (nova biomedical, Waltham, U.S.) and Enzym-linked Immunosorbent Assay (ELISA) using Bio-Rad (Bio-Rad Laboratories, California, U.S.)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Ability of Resuscitation Failure, Protein Carbonyl (PCO) and Receptor Interacting Protein Kinase 3 (RIPK3) for Predicting Mortality in Septic Patients | Probability of Mortality in Septic Patients with Resuscitation Failure, High PCO Level and High RIPK3 Level | 28 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| How Sensitive and Specific Protein Carbonyl (PCO) Level for Predicting Mortality in Septic Patients? | Sensitivity and Specificity of PCO Level for Predicting Mortality in Septic Patients | 28 days | 
| How Sensitive and Specific Receptor Interacting Protein Kinase 3 (RIPK3) Level for Predicting Mortality in Septic Patients? | Sensitivity and Specificity of RIPK3 Level for Predicting Mortality in Septic Patients | 28 days |