plasma soluble vascular endothelial growth factor receptor-1 levels predict outcomes of pneumonia-related septic shock patients a prospective observational study血浆可溶性血管内皮生长因子receptor-1水平预测结果相关的肺炎脓毒性休克患者的前瞻性研究.pdfVIP

Yang et al. Critical Care 2011, 15:R11 /content/15/1/R11 RESEARCH Open Access Plasma soluble vascular endothelial growth factor receptor-1 levels predict outcomes of pneumonia-related septic shock patients: a prospective observational study 1,2 3,4 4,5 1 1,4 Kuang-Yao Yang , Kuan-Ting Liu , Yu-Chun Chen , Chun-Sheng Chen , Yu-Chin Lee , 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 pro- inflammation, 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