Angiopoietin-2 Levels as Predictors of Outcome in Mechanically Ventilated Patients with Acute Respiratory Distress Syndrome

• Published in: Disease markers Vol. 2017; no. 2017; pp. 1 - 6
• Main Authors: Mavrou, Irini, Tsaknis, Georgios, Mouktaroudi, Maria, Kokori, Styliani, Orfanos, Stylianos, Giamarellos-Bourboulis, Evangelos J., Armaganidis, Apostolos, Konstantonis, Dimitrios, Antonakos, George, Zerva, Katerina, Pelekanou, Aimilia, Kopterides, P., Vrigkou, Eleni, Tsantes, Argirios, Tsangaris, Iraklis, Kyriazopoulou, Evdoxia
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2017; Hindawi; Hindawi Limited
• Subjects: Aged; Alveoli; Angiopoietin; Angiopoietin-2 - blood; Biomarkers - blood; C-Reactive Protein - metabolism; Endothelial cells; Endothelium; Failure; Female; Humans; Independent variables; Lungs; Male; Mechanical ventilation; Middle Aged; Mortality; Neoplasm Proteins - blood; Patients; Protein C; Proteoglycans - blood; Regression analysis; Respiration, Artificial - mortality; Respiratory distress syndrome; Respiratory Distress Syndrome, Adult - blood; Respiratory Distress Syndrome, Adult - therapy; Respiratory therapy; Ventilation
• ISSN: 0278-0240; 1875-8630
• DOI: 10.1155/2017/6758721

Pulmonary endothelium dysfunction is a key characteristic of ARDS. The aim of this study was to investigate endothelium-derived markers, such as angiopoietin-2 (Ang-2) and endothelial cell-specific molecule-1 (endocan), at the vascular and alveolar compartments as outcome predictors in ARDS. Fifty-three consecutive ARDS patients were studied. The primary outcome was 28-day mortality. Secondary endpoints were days of unassisted ventilation and days with organ failure other than ARDS, during the 28-day study period. Nonsurvivors presented higher lung injury scores and epithelial lining fluid (ELF) Ang-2 levels compared to survivors, with no significant differences in plasma Ang-2, endocan, and protein C concentrations between the two groups. In logistic regression analysis, ELF Ang-2 levels > 705 pg/ml were the only independent variable for 28-day mortality among the previous four. Plasma endocan values > 13 ng/pg were the only parameter predictive against days of unassisted ventilation during the 28-day study period. Finally, lung injury score > 2.25 and ELF Ang-2 levels > 705 pg/ml were associated with increased number of days with organ failure, other than ARDS. Our findings suggest that Ang-2 levels are increased in the alveolar compartment of ARDS patients, and this may be associated both with increased mortality and organ failure besides lung.