• Leonardo Lorente, María M Martín, Antonia Pérez-Cejas, José Ferreres, Jordi Solé-Violán, Lorenzo Labarta, César Díaz, and Alejandro Jiménez.
• Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n, La Laguna 38320, Tenerife, Spain. Electronic address: lorentemartin@msn.com.
• J Crit Care. 2017 Oct 1; 41: 177-182.

IntroductionSoluble CD40 ligand (sCD40L) is a protein with proinflammatory and prothrombotic effects. Previously we found higher circulating sCD40L levels in non-survivor than in survivor patients at sepsis diagnosis. Now some questions arise such as how are serum sCD40L levels during the first week of severe sepsis?, is there an association between serum sCD40L levels during the first week and mortality?, and serum sCD40L levels during the first week could be used as sepsis mortality biomarker?. This study was developed to answer these asks.MethodsStudy from 6 Spanish Intensive Care Units with 291 severe septic patients. There were determined serum levels of sCD40L and tumor necrosis factor (TNF)-alpha during the first week. The end-point study was 30-day mortality.ResultsWe found that serum sCD40L at days 1, 4, and 8 could predict mortality at 30days, and are associated with mortality.ConclusionsThe novel findings of our study were that there were higher serum sCD40L levels persistently during the first week in non-survivor than in survivor patients, that there is an association between serum sCD40L levels during the first week and sepsis mortality, and that serum sCD40L levels during the first week could be used as sepsis mortality biomarker.Copyright © 2017 Elsevier Inc. All rights reserved.

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