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Báo cáo y học: "The association of endothelial cell signaling, severity of illness, and organ dysfunction in sepsis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: The association of endothelial cell signaling, severity of illness, and organ dysfunction in sepsis. | Shapiro et al. Critical Care 2010 14 R182 http ccforum.eom content 14 5 R182 c CRITICAL CARE RESEARCH Open Access The association of endothelial cell signaling severity of illness and organ dysfunction in sepsis 1.2 1 1.2 1.2 3 5 Nathan I Shapiro Philipp Schuetz Kiichiro Yano Midori Sorasaki Samir M Parikh Alan E Jones Stephen Trzeciak6 Long Ngo4 William C Aird2 Abstract Introduction Previous reports suggest that endothelial activation is an important process in sepsis pathogenesis. We investigated the association between biomarkers of endothelial cell activation and sepsis severity organ dysfunction sequential organ failure assessment SOFA score and death. Methods This is a prospective observational study including adult patients age 18 years or older presenting with clinical suspicion of infection to the emergency department ED of an urban academic medical center between February 2005 and November 2008. Blood was sampled during the ED visit and biomarkers of endothelial cell activation namely soluble fms-like tyrosine kinase-1 sFlt-1 plasminogen activator inhibitors -1 PAI-1 sE-selectin soluble intercellular adhesion molecule sICAM-1 and soluble vascular cell adhesion molecule sVCAM-1 were assayed. The association between biomarkers and the outcomes of sepsis severity organ dysfunction and inhospital mortality were analyzed. Results A total of 221 patients were included sepsis without organ dysfunction was present in 32 severe sepsis without shock in 30 septic shock in 32 and 6 were non-infected control ED patients. There was a relationship between all target biomarkers sFlt-1 PAI-1 sE-selectin sICAM-1 and sVCAM-1 and sepsis severity P 0.05. We found a significant inter-correlation between all biomarkers including the strongest correlations between sFlt-1 and sE-selectin r 0.55 P 0.001 and between sFlt-1 and PAI-1 0.56 P 0.001 . Among the endothelial cell activation biomarkers sFlt-1 had the strongest association with SOFA score r 0.66 P 0.001 the highest area .