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J Clin Endocrinol Metab. 2006 Nov;91(11):4381-6. Epub 2006 Aug 29.

Copeptin and arginine vasopressin concentrations in critically ill patients.

Author information

1
Department of Anesthesiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. Stefan.Jochberger@uibk.ac.at

Abstract

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.

PMID:
16940457
DOI:
10.1210/jc.2005-2830
[Indexed for MEDLINE]
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