Diagnostics company SphingoTec GmbH ("sphingotec", Hennigsdorf Germany) today reported on new data on the utility of endothelial function biomarker bioactive Adrenomedullin (bio-ADM®). The data show that bio-ADM® allows identification of sepsis patients who are at high risk of fatal outcomes despite low or decreasing levels of the routinely monitored parameter lactate. Lactate, a parameter that identifies reduced blood oxygenation of tissue, is routinely used as a reference in the diagnosis of septic shock. However, lactate is rather unspecific to sepsis and insensitive. This limitation can be overcome by monitoring, in addition to lactate, the blood levels of bio-ADM®, a biomarker that can reliably detect blood vessel leakage, one of the main causes of septic shock.
According to recent findings published in Critical Care1, data from over 500 sepsis patients enrolled in the AdrenOSS-1 study demonstrate the added value of bio-ADM® to lactate monitoring. The AdrenOSS-1 study investigators could show that even though normalizing lactate levels indicate a significantly decreased risk of mortality, an additional measurement of bio-ADM® blood levels can help identify those patients that are still at risk of fatal outcomes despite their lower lactate levels. Among septic patients with decreasing lactate, high bio-ADM® levels identified patients who had a 4-time higher mortality risk than patients with low bio-ADM levels. According to the authors of the study, measurement of bio-ADM® on top of lactate may help refine risk stratification and thus guide resuscitation during sepsis.
Lactate has been used for more than 30 years to monitor organ hypoperfusion in sepsis patients. However, lactate blood levels are influenced by many other physiological and pathological processes. Clinical data from more than 22,000 patients demonstrate that high bio-ADM® levels independently from inflammation and co-morbidities indicate distortions in the barrier function of the inner cell sheet of blood vessels, the endothelium. Loss of this barrier function is considered a key driver in the development of hypotension and eventually septic shock with loss of organ perfusion in sepsis patients2. According to sphingotec's research, bio-ADM® can explain about 60% of the fatal outcomes in sepsis.
Our biomarker bio-ADM® can reliably support acute care physicians in identifying high-risk sepsis patients. We are set to launch the fully automated CE-IVD-marked point-of-care bio-ADM® assay on our widely established Nexus IB10 immunoassay instrument by mid-2020. We are convinced that this rapid test for bio-ADM® will support earlier treatment decisions and thereby will assist clinical decisions that may improve the outcomes of patients at ICUs and emergency departments."
Dr. Andreas Bergmann, founder and CEO of sphingotec
Blet, A., et al. (2020) Added value of serial bio-adrenomedullin measurement in addition to lactate for the prognosis of septic patients admitted to ICU. Critical Care. doi.org/10.1186/s13054-020-2794-x.