Endocan (endothelial cell-specific molecule-1) as a pertinent biomarker of endothelial dysfunction in sepsis

Abstract

Introduction In 2002, the Surviving Sepsis Campaign defi ned a strategy that aimed to reduce the high mortality due to sepsis. One point of this strategy was a recommendation to recognize that sepsis is a frequent cause of death and high economic costs in the pediatric intensive care unit. Knowledge of the disease is the fi rst step to impact it. There are few studies on pediatric sepsis epidemiology in the world and none in Colombia. Hypothesis The epidemiological features of Colombian children are diff erent from other countries. Methods We constructed a website where 14 intensive care units across the country reported in a prospective way the epidemiological features of children with sepsis using an electronic process [1]. We asked for sociodemographics, microbiological data, sepsis classifi cation, complications, and outcome. Results We collected 253 patients from March to May 2009. Fifty-fi ve percent of the cases were male and 45% were female; 53% were less than 1 year old. A total of 67.2% came from urban areas and 33% came from rural villages. Eighty-fi ve percent were very poor (score 1 and 2 over 6 used in Colombia as socioeconomic classifi cation). Forty-fi ve percent have governmentsupported insurance. In total, 23.72% of the population presented with sepsis; 30.04% with severe sepsis; and 46.5% with septic shock. The infection origin was respiratory in 54.55%, followed by abdominal in 17.39%. In 50.2% no cause was identifi ed. A total of 75.1% required mechanical ventilation. The mortality rate was 20.4%. Conclusions Sepsis, severe sepsis, or septic shock is a common diagnosis in Colombian intensive care units. The majority of pediatric patients are 2 years or younger and from the poorest communities. It aff ected males more. In the majority, the process starts in the respiratory system. We had diffi culty identifying the cause. The disease causes high mortality and cost for a developing society. We need a complete survey to fi nd a correct approach to the problem. Reference 1. Sepsis en Columbia [www.sepsisencolombia.com] P2 Randomized controlled trials are not designed to prove the safety of third-generation hydroxyethyl starch for resuscitation: results from a systematic review

Serum Endocan Levels in Children with Febrile Neutropenia

“…In another study of 36 patients being monitored in the intensive care unit for sepsis or septic shock, the serum endocan levels of 7 patients with systemic inflammatory response syndrome (SIRS) were found to be higher than those of a control group of 20 healthy subjects. 15 In addition, the measured serum endocan level of 12 patients who died after admittance to the intensive care unit were determined as higher than those of patients with 10-day survival in the intensive care unit. It is known that the infection agent can be shown microbiologically in lower percentage of febrile neutropenia patients, the most common infection agent has been observed to be bacteria.…”

Serum endocan levels in patients with habitual abortion

“…13 Research into patients with sepsis has shown a powerful link between disease severity and serum endocan levels, and has reported that this may indicate endothelial damage. 14,15 A study of patients with Behçet's disease performed in 2014 reported significantly higher serum endocan levels than in normal individuals. 16 Another study showed that disease activity in patients with psoriasis vulgaris and cardiovascular risk elevation were correlated with endocan level elevation.…”

“…Research into patients with sepsis has shown a powerful link between disease severity and serum endocan levels, and has reported that this may indicate endothelial damage 14,15 . A study of patients with Behçet's disease performed in 2014 reported significantly higher serum endocan levels than in normal individuals 16 .…”