Observational studyCritical care (London, England)2018
Circulating adrenomedullin estimates survival and reversibility of organ failure in sepsis: the prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock-1 (AdrenOSS-1) study.
Observational study in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02393781 (Adrenomedullin and Outcome in Severe Sepsis and Septic Shock. The AdrenOSS Study.), which is not on this map. Cited by 70 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Adrenomedullin and Outcome in Severe Sepsis and Septic Shock. The AdrenOSS Study.
Who cites it
70 citing papers in PubMed, 1 synthesis or guideline pooled it, 134 citations in OpenAlex.
- Clinical utility of proenkephalin A 119-159 for prediction of worsening renal function and prognosis in patients with sepsis -results of a patient-level meta-analysis.Critical care (London, England) · 2026Pooled it
- Trial
- Safety and tolerability of non-neutralizing adrenomedullin antibody adrecizumab (HAM8101) in septic shock patients: the AdrenOSS-2 phase 2a biomarker-guided trial.Intensive care medicine · 2021Trial
- Influence of adrenomedullin on the enzymatic activity of dipeptidyl peptidase 3Journal of enzyme inhibition and medicinal chemistry · 2026Article
- Bioactive adrenomedullin dynamics and microcirculatory changes in a porcine model of hemorrhagic shock.Intensive care medicine experimental · 2026Article
- Plasma proteomics defines two reproducible subphenotypes of sepsis-associated acute kidney injury with distinct outcomes.Nature communications · 2026Article
- Bioactive adrenomedullin as a point-of-care biomarker in emergency department patients with suspected severe infections: an exploratory analysis.BMC infectious diseases · 2026Article
- Cardiovascular Disease and COVID-19: Is There a Place for Mid-Regional Pro-Adrenomedullin? Preliminary Data from a Clinical Cohort.International journal of molecular sciences · 2025Article
- Kinetics of adrenomedullin pathway activation in a porcine sepsis model and a human cohort of sepsis and septic shock.Scientific reports · 2025Article
- Targeting high circulating dipeptidyl peptidase 3 in circulatory failure.Critical care (London, England) · 2025Review
- Bio-Adrenomedullin and Dipeptidyl Peptidase 3 as Novel Sepsis Biomarkers in the Emergency Department and the Intensive Care Unit: A Narrative Review.Medicina (Kaunas, Lithuania) · 2025Review
- Recovery of kidney function in acute kidney injury.Journal of nephrology · 2025Review
- Mixed Cardiogenic-Vasodilatory Shock: Current Insights and Future Directions.JACC. Advances · 2025Review
- Recent advances of precision immunotherapy in sepsis.Burns & trauma · 2025Review
- Utility of Adrenomedullin in Predicting Outcomes in Patients with Acute Febrile Illness in the Tropics: A Prospective Observational Study.The American journal of tropical medicine and hygiene · 2024Observational
- Sandwich immunoassay for adrenomedullin precursor and its practical application.Scientific reports · 2024Article
- Bioactive Adrenomedullin in Dogs with Sepsis and Septic Shock: A Prospective, Case-Control Study.Animals : an open access journal from MDPI · 2024Article
- Plasma bioactive adrenomedullin predicts mortality and need for dialysis in critical COVID-19.Scientific reports · 2024Article
- Navigating the Modern Landscape of Sepsis: Advances in Diagnosis and Treatment.International journal of molecular sciences · 2024Review
- Postoperative bioactive adrenomedullin is associated with the onset of ARDS and adverse outcomes in patients undergoing open thoracoabdominal aortic surgery.Scientific reports · 2024Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
30 authors at 11 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, we assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled trial.
methodsAdrenOSS-1 was a prospective observational multinational study. The primary outcome was 28-day mortality. Secondary outcomes included organ failure as defined by Sequential Organ Failure Assessment (SOFA) score, organ support with focus on vasopressor/inotropic use, and need for renal replacement therapy. AdrenOSS-1 included 583 patients admitted to the ICU with sepsis or septic shock.
resultsCirculating bio-ADM levels were measured upon admission and at day 2. Median bio-ADM concentration upon admission was 80.5 pg/ml [IQR 41.5-148.1 pg/ml]. Initial SOFA score was 7 [IQR 5-10], and 28-day mortality was 22%. We found marked associations between bio-ADM upon admission and 28-day mortality (unadjusted standardized HR 2.3 [CI 1.9-2.9]; adjusted HR 1.6 [CI 1.1-2.5]) and between bio-ADM levels and SOFA score (p < 0.0001). Need of vasopressor/inotrope, renal replacement therapy, and positive fluid balance were more prevalent in patients with a bio-ADM > 70 pg/ml upon admission than in those with bio-ADM ≤ 70 pg/ml. In patients with bio-ADM > 70 pg/ml upon admission, decrease in bio-ADM below 70 pg/ml at day 2 was associated with recovery of organ function at day 7 and better 28-day outcome (9.5% mortality). By contrast, persistently elevated bio-ADM at day 2 was associated with prolonged organ dysfunction and high 28-day mortality (38.1% mortality, HR 4.9, 95% CI 2.5-9.8).
conclusionsAdrenOSS-1 shows that early levels and rapid changes in bio-ADM estimate short-term outcome in sepsis and septic shock. These data are the backbone of the design of the biomarker-guided AdrenOSS-2 trial.
trial registrationClinicalTrials.gov, NCT02393781 . Registered on March 19, 2015.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.