Systemic Angiopoietin-1/2 Dysregulation in Pediatric Sepsis and Septic Shock
| Autor: | Carmen Mikacenic, W. Conrad Liles, Mark M. Wurfel, Jane E. Whitney, Melanie Silverman, Jackson S Norton, Elliot Melendez, Susanna Harju-Baker |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Inotrope
Male Adolescent Angiopoietin Severity of Illness Index Sepsis Endothelial activation Angiopoietin-2 03 medical and health sciences 0302 clinical medicine Severity of illness medicine Risk of mortality Angiopoietin-1 Humans Child Outcome Pediatric business.industry Septic shock Infant General Medicine Emergency department Biomarker medicine.disease Shock Septic Septic Shock Anesthesia Child Preschool cardiovascular system 030211 gastroenterology & hepatology Female business hormones hormone substitutes and hormone antagonists Biomarkers Research Paper |
| Zdroj: | International Journal of Medical Sciences |
| ISSN: | 1449-1907 |
| Popis: | Background: Angiopoietin-1 and -2 are vascular growth factors that exert opposing effects on endothelial activation and dysfunction. The aim of this study was to assess the association of these biomarkers with outcomes in children with sepsis. Methods: Biomarkers were assayed from the blood collected in an emergency department prior to any intervention. Predictor variables were Ang-1 and Ang-2 levels and the Ang-2/Ang-1 ratio. Outcomes included mortality, length of time on vasopressors, and ICU and hospital lengths of stay. The Pediatric RISk of Mortality III Score was calculated. A vasoactive inotrope score was calculated every 12 hours. Results: Forty-five children with sepsis and 49 with septic shock were analyzed. The median Ang-2 was higher in septic shock. The Ang-2/Ang-1 ratio was approximately 2-fold greater in those with septic shock. The Ang-2/Ang-1 ratio was associated with higher doses of vasoactive agents at 12 hours and longer ICU length of stay. In septic shock, for every 0.35 unit increase in the Ang-2/Ang-1 ratio, the PRISM III score increased by 1. Conclusions: The Ang-2/Ang-1 ratio was higher in children with septic shock. Ang-2/Ang-1 was associated with higher vasoactive agents, longer ICU length of stay, and correlated with the severity of illness score. |
| Databáze: | OpenAIRE |
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