Bactericidal/permeability-increasing protein (BPI) in sepsis correlates with the severity of sepsis and the outcome

Objective: To compare the prognostic significance of bactericidal/permeability-increasing protein (BPI), group II phospholipase A(2) (PLA(2)-II), C-reactive protein (CRP), tumour necrosis factor-ex (TNF), interleukin-8 (IL-8) and interferon-gamma (IFN) in terms of predicting severity of sepsis and outcome. Design: A prospective study. Setting:. Medical intensive care unit (UCI) of a university hospital. Patients: Thirty-four patients with severe sepsis requiring ICU treatment. Measurements and results: The levels of BPI, PLA(2)-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 PLA(2)-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, PLA(2)-II, TNF or IFN. The areas under the curve (AUCROCs) of SAPS II scores and IL-8 were higher than AUC(ROC) of BPI/neutrophil ratio. Conclusion: The 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.