{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T17:43:55Z","timestamp":1776707035703,"version":"3.51.2"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Ultrasound"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Septic shock is a severe form of sepsis marked by hypotension with an ominous outcome despite the introduction of modern intensive care. The aim of the present study is to obtain a panel with biomarkers, echocardiographic and vascular parameters to better risk stratify patients and identify those at higher risk of ominous outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Between May 2013 and April 2016, 35 consecutive patients admitted at the Intensive Care Unit (ICU) of ASST Great Metropolitan Hospital Niguarda with the diagnosis of severe sepsis or septic shock were enrolled. All patients underwent rest echocardiography and several circulating biomarkers of myocardial damage or oxidative stress.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The multivariate Cox\u2019s proportional hazard model showed that the only independent prognostic predictor for 30-day mortality was the angiopoietin-2, (HR 1.017, 95% CI 1.000\u20131.034; <jats:italic>P<\/jats:italic>\u2009=\u20090.049). An angiopoietin-2 concentrations \u2265 of 33,418\u2009pg\/mL was identified as the optimal threshold for the discrimination between survivors and non survivors at the time of admission in ICU, with a sensitivity of 80% and a specificity of 68%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Septic shock has a poor in-hospital outcome even when the best of care is implemented. Among the biochemical parameters angiopoietin was able to identify patients at risk of death. The lowest the value at admission, the highest the risk of in-hospital death. No echocardiographic nor vascular parameter was able to predict outcome in this setting.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12947-022-00276-3","type":"journal-article","created":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T22:03:56Z","timestamp":1648159436000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Biochemical but not imaging parameters are predictive of outcome in septic shock: a pilot study"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5086-8321","authenticated-orcid":false,"given":"Oriana E.","family":"Belli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonica","family":"Campolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Vallerio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Musca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Moreo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Maloberti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Parolini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Bonacchini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianpaola","family":"Monti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"De Gasperi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Fumagalli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Giannattasio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"issue":"1","key":"276_CR1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1001\/jama.2014.5804","volume":"312","author":"V Liu","year":"2014","unstructured":"Liu V, Escobar GJ, Greene JD, Soule J, Whippy A, Angus DC, et al. Hospital deaths in patients with sepsis from 2 independent cohorts. JAMA. 2014;312(1):90\u20132.","journal-title":"JAMA."},{"issue":"16","key":"276_CR2","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1056\/NEJMoa022139","volume":"348","author":"GS Martin","year":"2003","unstructured":"Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546\u201354.","journal-title":"N Engl J Med"},{"issue":"1","key":"276_CR3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3947\/ic.2014.46.1.1","volume":"46","author":"SY Cho","year":"2014","unstructured":"Cho SY, Choi JH. Biomarkers of sepsis. Infect Chemother. 2014;46(1):1\u201312.","journal-title":"Infect Chemother"},{"issue":"3","key":"276_CR4","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/joim.12331","volume":"277","author":"SM Opal","year":"2015","unstructured":"Opal SM, van der Poll T. Endothelial barrier dysfunction in septic shock. J Intern Med. 2015;277(3):277\u201393.","journal-title":"J Intern Med"},{"issue":"7","key":"276_CR5","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1093\/eurheartj\/ehr351","volume":"33","author":"G Landesberg","year":"2012","unstructured":"Landesberg G, Gilon D, Meroz Y, Georgieva M, Levin PD, Goodman S, et al. Diastolic dysfunction and mortality in severe sepsis and septic shock. Eur Heart J. 2012;33(7):895\u2013903.","journal-title":"Eur Heart J"},{"issue":"1","key":"276_CR6","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s40635-019-0252-3","volume":"7","author":"S Kazune","year":"2019","unstructured":"Kazune S, Grabovskis A, Cescon C, Strike E, Vanags I. Association between increased arterial stiffness and clinical outcomes in patients with early sepsis: a prospective observational cohort study. 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Crit Care Med. 2017;45(3):486\u2013552.","journal-title":"Crit Care Med"},{"issue":"1","key":"276_CR9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","volume":"28","author":"RM Lang","year":"2015","unstructured":"Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1\u201339.","journal-title":"J Am Soc Echocardiogr"},{"issue":"4","key":"276_CR10","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.echo.2016.01.011","volume":"29","author":"SF Nagueh","year":"2016","unstructured":"Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, et al. 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This study was approved by the Niguarda Ethics Committee \u201cMilano Area 3\u201d.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"All authors have given their consent for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The corresponding author states that there is no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"6"}}