• E Rintala, H Peuravuori, K Pulkki, L M Voipio-Pulkki, and T Nevalainen.
• Department of Medicine, Satakunta Central Hospital, Pori, Finland. esa.rintala@satshp.fi
• Intensive Care Med. 2000 Sep 1;26(9):1248-51.

ObjectiveTo compare the prognostic significance of bactericidal/permeability-increasing protein (BPI), group II phospholipase A2 (PLA2-II), C-reactive protein (CRP), tumour necrosis factor-alpha (TNF), interleukin-8 (IL-8) and interferon-gamma (IFN) in terms of predicting severity of sepsis and outcome.DesignA prospective study.SettingMedical intensive care unit (ICU) of a university hospital.PatientsThirty-four patients with severe sepsis requiring ICU treatment.Measurements And ResultsThe levels of BPI, PLA2-II, CRP, TNF, IL-8 and IFN were measured in these 34 patients. High levels of BPI were associated particularly with Gram-negative sepsis. BPI and BPI/neutrophil ratios correlated positively with PLA2-II, CRP, TNF and IL-8 and negatively with blood pressure. At 24 h, BPI/neutrophil ratios, IL-8 and Simplified Acute Physiology Scores II (SAPS II) scores were higher in non-survivors than in survivors. No such associations were noted in the levels of CRP, PLA2-II, TNF or IFN. The areas under the curve (AUC(ROC)s) of SAPS II scores and IL-8 were higher than AUC(ROC) of BPI/neutrophil ratio.ConclusionThe BPI and BPI/neutrophil ratios may serve as adjunctive tools to illustrate the severity of sepsis. However, their predictive power for sepsis-related death was not comparable to that of SAPS II scores and IL-8.

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