Impaired endothelium-dependent vasodilatation is a novel predictor of mortality in intensive care*

Abstract

In vivo bedside assessment of endothelium-dependent vasodilatation is an independent predictor of mortality in the critically ill. We have shown it to be superior to other validated severity of illness scores with high sensitivity and specificity.

Biomarkers of endothelial dysfunction: can they help us deciphering systemic inflammation and sepsis?

“…Endothelial dysfunction is a broad term, which is mainly used to refer to an imbalance of vasoconstriction, vasodilatation and vascular leakage, and edema formation. The endothelial injury, therefore, plays a key role during sepsis pathogenesis and is highly associated with mortality (Duffy et al 2011). Tissue edema may rapidly impair organ function by elongating the oxygen diffusion distance, favoring the formation of microthrombi with consequent breakdown of adequate organ perfusion (Lee and Slutsky 2010).…”

Endothelial dysfunction is a potential contributor to multiple organ failure and mortality in aged mice subjected to septic shock: preclinical studies in a murine model of cecal ligation and puncture

“…Although the development of endothelial dysfunction is well established in various forms of shock, both in preclinical models [3–9] and in patients [10–14], to our knowledge, it has not been previously investigated whether endothelial dysfunction associated with aging worsens the outcome and increases mortality rates of septic shock. Thus, the purpose of the current study was to investigate, in a murine model of cecal ligation and puncture-induced septic shock, whether aging increases the severity of endothelial dysfunction, leading to a worsening of oxidative stress, tissue inflammation and, ultimately, multiple organ dysfunction syndrome (MODS) and death.…”

Endothelial Dysfunction Is a Potential Contributor to Multiple Organ Failure and Mortality in Aged Mice Subjected to Septic Shock: Preclinical Studies in a Murine Model of Cecal Ligation and Puncture

“…Several lines of evidence support the view that endothelial dysfunction is a key factor in promoting coagulation abnormalities, multiple organ failure and mortality in sepsis in humans, as well [9,21]. Importantly, in septic patients, the degree of the loss of endothelium-dependent vasorelaxant responsiveness shows a close correlation with mortality [13,14,23].…”

“…One of the principal causes of mortality in sepsis is progressive vascular dysfunction. As first shown over 20 years ago [3,4], and repeatedly confirmed by multiple studies since then [5][6][7][8][9][10][11][12][13][14], various forms of circulatory shock are associated with the development of endothelial dysfunction, that is an impaired ability of the endothelial cells to produce NO. Several lines of evidence support the view that endothelial dysfunction is a key factor in promoting coagulation abnormalities, multiple organ failure and mortality in sepsis in humans, as well [9,21].…”

“…Although the development of endothelial dysfunction is well established in various forms of shock, both in preclinical models [3][4][5][6][7][8][9] and in patients [10][11][12][13][14], to our knowledge, it has not been previously investigated whether endothelial dysfunction associated with aging worsens the outcome and increases mortality rates of septic shock. Thus, the purpose of the current study was to investigate, in a murine model of cecal ligation and puncture-induced septic shock, whether aging increases the severity of endothelial dysfunction, leading to a worsening of oxidative stress, tissue inflammation and, ultimately, multiple organ dysfunction syndrome (MODS) and death.…”