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Medicina crítica (Colegio Mexicano de Medicina Crítica)

Print version ISSN 2448-8909

Abstract

MONARES ZEPEDA, Enrique et al. The levels of acetylcholinesterase in patients with hemodynamic instability discard sepsis as a cause of shock. Med. crít. (Col. Mex. Med. Crít.) [online]. 2018, vol.32, n.5, pp.285-289.  Epub June 30, 2020. ISSN 2448-8909.

Introduction:

Early detection of sepsis is essential to reduce mortality from this condition. So far, no clinical scale or biomarker has been useful in its diagnosis and early detection. Levels of acetylcholinesterase activity have been proposed as a very promising biomarker for the detection of sepsis and septic shock.

Objective:

To study the usefulness of acetylcholinesterase levels in the diagnosis of sepsis.

Material and methods:

Observational and prospective study in patients of the Intensive Care Unit of the Hospital San Ángel Inn Universidad with diagnosis of hemodynamic instability, classified with or without sepsis, taking acetylcholinesterase levels at admission.

Results:

44 patients were evaluated, 27% with sepsis. The acetylcholinesterase values ​​presented a normal distribution and had diagnostic validity to predict sepsis (AUC: 0.852 95% CI: 0.726-0.977, p < 0.001), with a cut-off value of < 3,956 U/L, sensitivity = 81%, specificity = 75%. The value of neutrophils with a cut < 74% also had a predictive value of sepsis (AUC: 0.710 95% CI: 0.512-0.907, p = 0.034) sensitivity = 75%, specificity = 75%.

Conclusions:

In patients with hemodynamic instability with acetylcholinesterase levels greater than 4,000 U/L, sepsis is ruled out as the cause of shock.

Keywords : Serum acetylcholinesterase activity; biomarker; sepsis; septic shock; SIRS.

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