tailieunhanh - Báo cáo y học: " Plasma soluble vascular endothelial growth factor receptor-1 levels predict outcomes of pneumonia-related septic shock patients: a prospective observational study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Plasma soluble vascular endothelial growth factor receptor-1 levels predict outcomes of pneumonia-related septic shock patients: a prospective observational study. | Yang et al. Critical Care 2011 15 R11 http content 15 1 R11 cs CRITICAL CARE RESEARCH Open Access Plasma soluble vascular endothelial growth factor receptor-1 levels predict outcomes of pneumonia-related septic shock patients a prospective observational study Kuang-Yao Yang1 2 Kuan-Ting Liu3 4 Yu-Chun Chen4 5 Chun-Sheng Chen1 Yu-Chin Lee1 4 Reury-Perng Perng1 4 Jia-Yih Feng1 2 Abstract Introduction Despite recent advances in the management of septic shock mortality rates are still unacceptably high. Early identification of the high-mortality risk group for early intervention remains an issue under exploration. Vascular endothelial growth factor VEGF soluble vascular endothelial growth factor receptor-1 sVEGFR1 and urokinase plasminogen activator uPA have diverse effects in the pathogenesis of sepsis which involve proinflammation anti-inflammation endothelial cell repair and vascular permeability change. Their roles in predicting mortality and organ dysfunction remain to be clarified. Methods Pneumonia-related septic shock patients from medical intensive care units were enrolled for this prospective observational study. We also included 20 patients with pneumonia without organ dysfunction for comparison. Plasma levels of VEGF and sVEGFR1 and uPA activity within 24 hours of shock onset were measured. We compared plasma levels of these biomarkers with APACHE II scores between subgroups of patients and evaluated their predictive value for 28-day mortality and organ dysfunction. Results A total of 101 patients including 81 with pneumonia-related septic shock and 20 with pneumonia without organ dysfunction were enrolled. Non-survivors of septic shock had significantly higher plasma sVEGFR1 levels vs. pg mL respectively P and uPA activity vs. units respectively P when compared with those of the survivors. Kaplan-Meier survival analysis demonstrated significantly higher mortality in patients with higher .