This Article Full Text Full Text (PDF) All Versions of this Article: 91/11/4381    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jochberger, S. Articles by Dünser, M. W. Search for Related Content PubMed PubMed Citation Articles by Jochberger, S. Articles by Dünser, M. W. Related Collections Neuroendocrinology and Pituitary

Copeptin and Arginine Vasopressin Concentrations in Critically Ill Patients

Department of Anesthesiology (S.J., V.D.M., G.L., V.W., B.E.F.), Institute of Medical Biostatistics (H.U.), and Division of Experimental Pathophysiology and Immunology, Biocenter (S.S.), Innsbruck Medical University, A-6020 Innsbruck, Austria; Department of Research (N.G.M.), B.R.A.H.M.S. Aktiengesellschaft D-16761, Hennigsdorf, Germany; Department of Anesthesiology and Critical Care Medicine (W.R.H.), Krankenhaus der Barmherzigen Schwestern, A-4910 Ried im Innkreis, Austria; and Department of Intensive Care Medicine (M.W.D.), University Hospital of Bern, CH-3010 Bern, Switzerland

Address all correspondence and requests for reprints to: Stefan Jochberger, M.D., Department of Anesthesiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. E-mail: Stefan.Jochberger{at}uibk.ac.at.

Context: Determination of arginine vasopressin (AVP) concentrations may be helpful to guide therapy in critically ill patients. A new assay analyzing copeptin, a stable peptide derived from the AVP precursor, has been introduced.

Objective: Our objective was to determine plasma copeptin concentrations.

Design: We conducted a post hoc analysis of plasma samples and data from a prospective study.

Setting: The setting was a 12-bed general and surgical intensive care unit (ICU) in a tertiary university teaching hospital.

Patients: Our subjects were 70 healthy volunteers and 157 ICU patients with sepsis, with systemic inflammatory response syndrome (SIRS), and after cardiac surgery.

Interventions: There were no interventions.

Main Outcome Measures: Copeptin plasma concentrations, demographic data, AVP plasma concentrations, and a multiple organ dysfunction syndrome score were documented 24 h after ICU admission.

Results: AVP (P < 0.001) and copeptin (P < 0.001) concentrations were significantly higher in ICU patients than in controls. Patients after cardiac surgery had higher AVP (P = 0.003) and copeptin (P = 0.003) concentrations than patients with sepsis or SIRS. Independent of critical illness, copeptin and AVP correlated highly significantly with each other. Critically ill patients with sepsis and SIRS exhibited a significantly higher ratio of copeptin/AVP plasma concentrations than patients after cardiac surgery (P = 0.012). The American Society of Anesthesiologists’ classification (P = 0.046) and C-reactive protein concentrations (P = 0.006) were significantly correlated with the copeptin/AVP ratio.

Conclusions: Plasma concentrations of copeptin and AVP in healthy volunteers and critically ill patients correlate significantly with each other. The ratio of copeptin/AVP plasma concentrations is increased in patients with sepsis and SIRS, suggesting that copeptin may overestimate AVP plasma concentrations in these patients.

This article has been cited by other articles:

				S. Neuhold, M. Huelsmann, G. Strunk, B. Stoiser, J. Struck, N. G. Morgenthaler, A. Bergmann, D. Moertl, R. Berger, and R. Pacher Comparison of Copeptin, B-Type Natriuretic Peptide, and Amino-Terminal Pro-B-Type Natriuretic Peptide in Patients With Chronic Heart Failure: Prediction of Death at Different Stages of the Disease J. Am. Coll. Cardiol., July 22, 2008; 52(4): 266 - 272. [Abstract] [Full Text] [PDF]

				G. Szinnai, N. G. Morgenthaler, K. Berneis, J. Struck, B. Muller, U. Keller, and M. Christ-Crain Changes in Plasma Copeptin, the C-Terminal Portion of Arginine Vasopressin during Water Deprivation and Excess in Healthy Subjects J. Clin. Endocrinol. Metab., October 1, 2007; 92(10): 3973 - 3978. [Abstract] [Full Text] [PDF]

				M. Christ-Crain and B. Muller Biomarkers in respiratory tract infections: diagnostic guides to antibiotic prescription, prognostic markers and mediators Eur. Respir. J., September 1, 2007; 30(3): 556 - 573. [Abstract] [Full Text] [PDF]