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Increased Endothelial Injury in Septic Patients With Coronary Artery Disease
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Journal Article
Increased Endothelial Injury in Septic Patients With Coronary Artery Disease
2001
Overview
Recently, it was proposed that solubleintercellular adhesion molecule (sICAM)-1 plasma levels may allowsubgroup identification of patients at risk for cardiovascularcomplications during sepsis. However, the impact of preexistingcoronary artery disease (CAD) on these results has not yet been tested. The aim of this study was to investigate whether plasma levels of adhesion molecules, nitric oxide, and cytokines differ between septicpatients with or with out preexisting CAD.
Prospective study.
Surgical ICU.
Forty-four septic patients, 24 of whom met thecriteria of CAD.
Hemodynamic measurementswere performed and blood samples were taken with in 12 h afteronset of sepsis (early sepsis) and again 72 h thereafter (latesepsis). Soluble adhesion molecules and cytokines were determined usingcommercially available enzyme-linked immunosorbent assay kits, cyclicguanosinomonophosphate (cGMP) by competitive radioimmunoassay, and nitrite/nitrate photometrically by Griess reaction.
In CAD patients, sICAM-1 (p < 0.02) wassignificantly elevated in early and late sepsis, whereas solubleendothelial-linked adhesion molecule (sE-selectin; p < 0.01) and cGMP (p < 0.03) were only increased in late sepsis. Oxygenconsumption did not significantly differ between groups. Oxygendelivery and mixed venous oxygen saturation during early and latesepsis were significantly diminished and the oxygen extraction ratiosignificantly increased in the CAD group (p < 0.05).
Increased endothelial injury may be indicatedby the elevated levels of sICAM-1, sE-selectin, and cGMP in septicpatients with preexisting CAD. These parameters, however, failed toserve as predictors for unknown CAD or chances for survival in earlysepsis.
Publisher
Elsevier Inc,American College of Chest Physicians
Subject
/ Biological and medical sciences
/ Cell Adhesion Molecules - blood
/ Coronary Disease - complications
/ Coronary Disease - pathology
/ Endothelium, Vascular - pathology
/ Enzyme-Linked Immunosorbent Assay
/ Female
/ Heart
/ Humans
/ Intercellular Adhesion Molecule-1 - blood
/ Male
/ Multiple organ dysfunction syndrome
/ Plasma
/ Sepsis
/ Trauma
