title: Evaluation of endothelial biomarkers as predictors of organ failures in septic shock patients.
abstract: BACKGROUND
  Endothelial injury is recognized to trigger organ failures during the first 48h of septic shock. We evaluate endothelial biomarkers at ICU admission in their ability to predict severity, outcome, and organ failures in septic shock patients.
  
  
  METHODS
  This prospective observational pilot study was conducted in a medical intensive care unit of a university hospital. Plasma levels of endothelial biomarkers as angiopoietin-2, sE-selectin or endocan were measured at ICU admission of 20 patients presenting with septic shock. Clinical and biological data were recorded at inclusion and each day during the first week.
  
  
  RESULTS
  Significant correlations were found between angiopoietin-2 and severity scores at Day 1: SAPS2 (r(2)=0.620; p=0.004) and LOD score (r(2)=0.681; p=0.001). The angiopoietin-2 level was significantly higher in patients presenting with organ failure such as hemodynamic, renal or hepatic failure. It correlated with catecholamine infusion dose and was higher in non survivors compared with survivors (33.5 [28.9-51.4] vs. 12.4 [6.4-14.7]ng/ml; p=0.001). In contrast, in that population presenting with septic shock, endocan level at inclusion was not related to any organ failure at inclusion or Day 1 but appeared lower in patients presenting with respiratory failure at Day 3 compared to those who do not (1.9 [0.99-3.1] vs 5.2 [3.1-17.2]ng/ml; p=0.032). The endocan level at inclusion was correlated with the decrease in PaO2/FiO2 ratio at Day 2 (r(2)=0.628; p=0.0004) and Day 3 (r(2)=0.645; p=0.005). Endocan level <2.54ng/ml at admission is predictive of a respiratory failure presence at Day 3.
  
  
  CONCLUSIONS
  In septic shock patients, angiopoietine-2 is related with clinical severity during the first 24h but only endocan is able to predict the presence of respiratory failure at Day 3.
authors: CHRU Lille, Hôpital Salengro, F-59037 Lille, France; Universite Lille Nord de France, F-59000 Lille, France.
authors: Aurore
authors: A
authors: Palud
authors: CHRU Lille, Hôpital Salengro, F-59037 Lille, France; Universite Lille Nord de France, F-59000 Lille, France.
authors: Erika
authors: E
authors: Parmentier-Decrucq
authors: CHRU Lille, Hôpital Salengro, F-59037 Lille, France.
authors: Jean
authors: J
authors: Pastre
authors: Lunginnov, F-59000 Lille, France; Institut National de la Santé et de la Recherche Médicale, U1019E11, F-59019 Lille, France.
authors: Nathalie
authors: N
authors: De Freitas Caires
authors: Lunginnov, F-59000 Lille, France; Institut National de la Santé et de la Recherche Médicale, U1019E11, F-59019 Lille, France; CNRS, UMR 8204, F-59021 Lille, France; Institut Pasteur de Lille, Center for Infection and Immunity of Lille, F-59019 Lille, France.
authors: Philippe
authors: P
authors: Lassalle
authors: CHRU Lille, Hôpital Salengro, F-59037 Lille, France; Universite Lille Nord de France, F-59000 Lille, France. Electronic address: daniel.mathieu@chru-lille.fr.
authors: Daniel
authors: D
authors: Mathieu
mesh_terms: D000368:Aged; D042702:Angiopoietin-2; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D003710:Demography; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood*; D009363:Neoplasm Proteins / Q000097:blood; D011379:Prognosis; D011509:Proteoglycans / Q000097:blood; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality
chemical_list: D042702:Angiopoietin-2; D015415:Biomarkers; D019040:E-Selectin; C101134:ESM1 protein, human; D009363:Neoplasm Proteins; D011509:Proteoglycans
keywords: ARDS; Angiopoietin-2; Biomarker; Endocan; Sepsis