These catheters and blood samples are part of the routine hemo-dynamic monitoring and assessment of the critically ill patient in our ICU. All these parameters are delivered by the blood gas analyser located in the ICU from an arterial and a venous blood sample of 1.5 ml each drawn via the arterial and central venous line respectively.

The status of the microcirculation is assessed using clinical signs (mottling score, capillary refill time and sublingual microcirculation functional status) and laboratory parameters reflecting the degree of tissue oxygen extraction such as SaO2-SvO2 gap, Pv-aCO2 gap and the arterial lactate concentration. SAPS II and SOFA scores are part of the routine assessment of all our patients in the ICU and are used as quality indicators. The SAPS-II will be assessed on Visit 3 and the SOFA daily using the information obtained during the routine clinical examination and the laboratory results of the day. SAPS-II reflects the physiological status of the patient within the first 24 hours (admission severity) and the SOFA score the number of failing organs (respiration, coagulation, liver, cardiovascular, CNS, renal). The severity of illness of the patient will be assessed using the SAPS II score and the SOFA score. Clinical evaluation of the patients will take place each morning including the evaluation of the hemodynamics, organ dysfunction, microcirculation and the need for vasopressors. The blood samples will be collected together with the routine blood check on admission, as well as each morning. If a patient is discharged before day 7, no further measurements will be performed. The values of MR-proADM and CT-proET-1 will be measured daily over the first 7 days of the ICU stay. The Charlson comorbidity index is calculated based on the medical history of the patient. This information is obtained routinely in every patient in our ICU. After obtaining informed consent of the patient or approval of a legal representative and meeting of the inclusion, as well as missing exclusion criteria the patients will be enrolled.Īt study enrolment patient health status will be assessed by health related diagnosis and the Charlson comorbidity index. This pilot-study will be a prospective, single-centre, observational study including 100 critically ill patients consecutively admitted to the medical intensive care unit (ICU) of the University hospital of Zurich, Switzerland, to assess and validate the use of MR-proADM and the CT-proET1/MR-proADM-ratio as prognostic markers in critically ill patients. Why Should I Register and Submit Results?.

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