Circulating angiopoietin-2 levels in the course of septic shock: relation with fluid balance, pulmonary dysfunction and mortality.
OBJECTIVE
To investigate whether angiopoietin-2, von Willebrand factor (VWF) and angiopoietin-1 relate to surrogate indicators of vascular permeability, pulmonary dysfunction and intensive care unit (ICU) mortality throughout the course of septic shock.


METHODS
In 50 consecutive mechanically ventilated septic shock patients, plasma angiopoietin-2, VWF and angiopoietin-1 levels and fluid balance, partial pressure of oxygen/inspiratory oxygen fraction and the oxygenation index as indicators of vascular permeability and pulmonary dysfunction, respectively, were measured until day 28.


RESULTS
Angiopoietin-2 positively related to the fluid balance and pulmonary dysfunction, was higher in non-survivors than in survivors and independently predicted non-survival throughout the course of septic shock. VWF inversely related to the fluid balance and pulmonary dysfunction throughout the course of septic shock, was comparable between survivors and non-survivors and predicted non-survival on day 0 only. Angiopoietin-1 positively related to pulmonary dysfunction throughout the course, but did not differ between survivors and non-survivors.


CONCLUSIONS
In contrast to VWF, plasma angiopoietin-2 positively relates to fluid balance, pulmonary dysfunction and mortality throughout the course of septic shock, in line with a suggested mediator role of the protein.
van der Heijden
Melanie
M
Department of Intensive Care, VU University Medical Centre, Amsterdam, The Netherlands. m.vanderheijden@vumc.nl
Pickkers
Peter
P
van Nieuw Amerongen
Geerten P
GP
van Hinsbergh
Victor W M
VW
Bouw
Martijn P W J M
MP
van der Hoeven
Johannes G
JG
Groeneveld
A B Johan
AB
D055371:Acute Lung Injury; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042702:Angiopoietin-2 / Q000097:blood*; D002199:Capillary Permeability; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D012772:Shock, Septic / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D014882:Water-Electrolyte Balance; D055815:Young Adult; D014841:von Willebrand Factor / Q000032:analysis
D042702:Angiopoietin-2; D014841:von Willebrand Factor