Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

Severe sepsis and septic shock represent one of the oldest and most pressing problems in medicine. With advances in intensive care, increased awareness, and dissemination of evidence based guidelines, clinicians have taken large strides in reducing the risk of imminent death associated with sepsis. Now days sepsis markers are currently more useful to rule out a diagnosis of sepsis than to actually identify sepsis, but potential new markers are being identified all the time. Heparin binding protein (HBP; also known as azurocidin and CAP37) is a multifunctional inflammatory mediator which is contained within the secretory and azurophilic granulae of human neutrophils and is secreted upon stimulation of the leukocytic membrane-bound Ý2-integrins. This protein is strongly involved in the pathophysiology of severe bacterial infections, and thus represents a potential diagnostic marker and a target for treatment. The present study was designed to evaluate the value of repeated measurements of heparin binding protein serum level in predicting the outcome in critically ill patients diagnosed with severe sepsis and septic shock compared to serum level of C- reactive protein and arterial lactate level. Our study consisted of 20 Egyptian non septic patients and they are considered the control group and randomized 40 Egyptian patients who were admitted to our ICU unit with picture of severe sepsis and septic shock and we have done repeated measurements of serum level of HBP, CRP and arterial lactate to the three groups on admission, on day 2 and day 4 comparing their values in prediction of outcome in severe sepsis and septic shock patients in ICU after 14 days follow up

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