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Plasma Endothelin-1 Levels in Septic Patients

Department of Anaesthesiology and Intensive Care Unit, Medical University of Lodz, Poland

Maciej Banach, MD, PhD

Department of Cardiology, Medical University of Lodz, Poland, m.banach{at}termedia.pl

Robert Irzmanski, MD, PhD

Department of Internal Diseases and Cardiological Rehabilitation, Medical University of Lodz, Poland

Marcin Barylski, MD

Department of Internal Diseases and Cardiological Rehabilitation, Medical University of Lodz, Poland

Magdalena Piechota-Urbanska, MD

Department of Pharmacy, Medical University of Lodz, Poland

Jan Kowalski, MD, PhD

Department of Internal Diseases and Cardiological Rehabilitation, Medical University of Lodz, Poland

Lucjan Pawlicki, MD, PhD

Department of Internal Diseases and Cardiological Rehabilitation, Medical University of Lodz, Poland

Dysfunction of the vascular endothelium (ET) causes an increase in serum ET-1 concentration, as observed in septic patients. It was assumed that in this patient population the ET-1 level correlates with the degree of sepsis severity, including the level of organ dysfunction and, in particular, the level of circulatory dysfunction. The aim of the present study was to assess the relationship between levels of ET-1 and levels of N-terminal brain natriuretic propeptide (NT-proBNP), procalcitonin (PCT), and C-reactive protein (CRP), as well as the Sepsis-related Organ Failure Assessment (SOFA) score in septic patients. PCT and CRP were used to estimate the level of sepsis severity; the SOFA score was used to estimate multiorgan dysfunction; and NT-proBNP was used as a marker of cardiac dysfunction. Twenty patients with sepsis and severe sepsis were included in the study. Blood serum ET-1, NT-proBNP, PCT, and CRP concentrations were determined at specific time intervals, and the SOFA score was calculated. Mean ET-1, NT-proBNP, PCT, and CRP concentrations were 8.39 pg/ml ± 6.39 pg/mL, 140.80 pg/mL ± 84.65 pg/mL, 22.32 ng/mL ± 97.41 ng/mL, and 128.51 mg/L ± 79.05 mg/L, respectively. Correlation between ET-1 levels and levels of NT-proBNP, PCT, and CRP was .3879 (P < .001), .358 (P < .001), and .225 (P = .011), respectively. Mean SOFA score was 6.31 pts ± 3.75 pts. Correlation between the ET-1 levels and SOFA score was .470 (P < .001). Six patients (30%) died during the observation period of 28 days. ET-1 levels correlate with levels of NT-proBNP, PCT, and CRP, as well as the SOFA score in septic patients.

Key Words: Endothelin-1 • Sepsis-related Organ Failure Assessment score • N-terminal brain natriuretic propeptide • procalcitonin • C-reactive protein • sepsis • severe sepsis

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