Faculty Research
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Sheila Alexander, Phd, RN
| Department: |
Acute & Tertiary Care |
| Location: |
367B Victoria Building |
| Email: |
salexand@pitt.edu |
| Phone: |
412/624-3831 |
Keywords:
- Apolipoprotein E
- Calcium
- Cerebral Vasospasm
- Cerebrospinal Fluid
- Subarachnoid Hemorrhage
Current Funded Research:
Alexander, S.
02/02/2008 - 2/21/2010
SSCM
Apolipoprotein E Inflammatory Markers and Delirium in ICU Patients
Delirium, a disturbance in consciousness with
inattention accompanied by a change in cognition or perceptual disturbances, is a common occurrence in
hospitalized patients in and out of the ICU. Factors increasing risk for the development of delirium include
increasing age, metabolic disturbances, electrolyte imbalances, drug/alcohol withdrawal, infection, seizures,
dehydration, hyperthermia, head trauma, vascular disorders, intracranial space occupying lesions and others.
Delirium in the ICU has been associated with prolonged ICU stay, prolonged hospital stay, and poorer outcome.
Currently, there are no biomarkers available to predict delirium onset or duration in ICU patients. Recent
research has identified a potential association between presence of the apolipoprotein E (APOE) 4 allele, a gene
with known influence on neurologic recovery and disease, and delirium in ICU patients.
This study will explore the relationship between APOE 4 allele presence, serum apoE protein levels,
serum cytokine levels (IL-1, IL-6, IL-8, and IL-10) and development and duration of delirium in ICU patients.
Subjects will be identified upon admission to the ICU and consent obtained by a clinical nurse collaborating
with the research team. Blood will be drawn upon enrollment and daily for the first 5 days of admission. DNA
will be extracted from the first blood sample drawn. Serum will be extracted from each sample for apoE protein
and cytokine quantification. Delirium will be assessed daily by the clinical nurse using the confusion
assessment method-ICU (CAM-ICU). Chi-square analysis and repeated measures analysis of variance will be
used to explore associations between APOE 4 allele presence and development/duration of delirium.
Hierarchical linear and nonlinear modeling will be used to explore the relationship between APOE genotype,
apoE protein level, and cytokine level and delirium development/duration. Identification of a genetic biomarker
for individuals at risk for delirium would aid in focusing nursing care on individuals at risk and formation of
individualized care to improve outcome.
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