Is Endocan a Diagnostic Marker for Pneumonia After Cardiac Surgery? The ENDOLUNG Study

Perrotti, Andréa; Chenevier‐Gobeaux, Camille; Ecarnot, Fiona; Bardonnet, Karine; Barrucand, Benoit; Flicoteaux, Guillaume; Lassalle, Philippe; Chocron, Sidney

doi:10.1016/j.athoracsur.2017.07.031

Cited by 19 publications

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“…Higher perioperative concentrations of endocan were observed in patients with the longest duration of norepinephrine support ( p = 0.007) [ 38 ]. Patients developing POP exhibited higher blood endocan levels before surgery and at 6 h post surgery than those who did not develop POP (Table 2 ) [ 42 , 43 ]. Thus, endocan allowed earlier identification of patients evolving to POP than PCT or CRP [ 35 , 36 ].…”

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confidence: 99%

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Endocan, sepsis, pneumonia, and acute respiratory distress syndrome

et al. 2018

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Acute respiratory distress syndrome (ARDS) and hospital-acquired pneumonia (HAP) are major problems of public health in intensive care units (ICUs), occurring in 15% of critically ill patients. Among the factors explaining ARDS development, sepsis is known as a frequent cause. Sepsis, ARDS, and HAP increase morbidity, mortality, length of stay in the ICU, and the overall costs of healthcare. The major challenge remains to identify accurately among critically ill patients those at risk of poor outcomes who could benefit from novel therapies. Endocan is released by the pulmonary endothelium in response to local or systemic injury. It inhibits mainly leukocyte diapedesis rather than leukocyte rolling or adhesion to the endothelial cells both in vitro and in vivo. Endocan was evaluated in 25 clinical reports, including 2454 critically ill patients and 452 healthy controls. The diagnostic value of endocan for sepsis or sepsis severity was equal to procalcitonin but its prognostic value was better. A predictive value for postoperative pneumonia was evidenced in two studies, and a predictive value for ARDS in four studies from three independent centers. This review presents an overview of the structure, expression, and functions of endocan. We also hereby summarize the potential applications of endocan in the prediction and prognosis of ARDS and HAP, as well as in the prognosis of sepsis.

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confidence: 99%

“…Blood endocan levels at 12 h, 24 h, or 48 h post surgery were less discriminant. In routine practice, the average time to a formal diagnosis of pneumonia after cardiac surgery is 4.6 ± 3.7 days [ 43 ]. Blood endocan > 15 ng/ml 6 h after cardiac surgery had a sensitivity of 80% and a specificity of 100% to predict POP [ 42 ].…”

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Endocan, sepsis, pneumonia, and acute respiratory distress syndrome

et al. 2018

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“…Increased concentrations of endocan has been shown to be associated with a bad prognosis in patients with severe sepsis [11] or trauma [12]. In cardiac surgery with CPB, the influence of CPB on the kinetic of endocan concentrations is still unknown [13,14], even the preoperative value of endocan was recently shown as an early marker of postoperative pneumonia [15].…”

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confidence: 99%

Postoperative serum levels of Endocan are associated with the duration of norepinephrine support after coronary artery bypass surgery

Bouglé

Allain

Favard

et al. 2018

Anaesthesia Critical Care & Pain Medicine

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Serum Endocan concentration increases after CABG surgery with CPB until day 1. The norepinephrine support increases the risk of Endocan release, suggesting a relationship between the kinetic of Endocan and the vasoplegic syndrome. At day 3, Endocan concentration decreases slowly but is not normalised at day 5. Further studies should investigate the prognostic value of the magnitude of postoperative Endocan concentration after cardiac surgery.

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“…More generic markers of vascular function or nutritional status have shown more promising results. Recent studies including 155 CABG patients and 262 patients undergoing elective gastrectomy, endothelial cell‐specific molecule 1 (Endocan) or albumin concentrations, respectively, predicted postoperative pneumonia while C‐reactive protein was only predictive in univariate analysis in the latter study …”

Section: Discussionmentioning

confidence: 99%

“…Recent studies including 155 CABG patients and 262 patients undergoing elective gastrectomy, endothelial cell-specific molecule 1 (Endocan) or albumin concentrations, respectively, predicted postoperative pneumonia while C-reactive protein was only predictive in univariate analysis in the latter study. 22,23 Elevated RDW has been reported to associate with mortality and adverse events in CVD and cancer. 4,[24][25][26][27][28] In non-cardiovascular diseases, RDW has been associated with poor outcome in patients with diabetes, kidney disease, respiratory disorders and rheumatoid arthritis.…”

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confidence: 99%

A single preoperative blood test predicts postoperative sepsis and pneumonia after coronary bypass or open aneurysm surgery

Koeverden

Ruijter

Scholtes

et al. 2019

Eur J Clin Investigation

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Background Major surgery comes with a high risk for postoperative inflammatory complications. Preoperative risk scores predict mortality risk but fail to identify patients at risk for complications following cardiovascular surgery. We therefore assessed the value of preoperative red cell distribution width (RDW) as a predictor for pneumonia and sepsis after cardiovascular surgery and studied the relation of RDW with hematopoietic tissue activity. Methods RDW is an easily accessible, yet seldomly used parameter from routine haematology measurements. RDW was extracted from the Utrecht Patient Orientated Database (UPOD) for preoperative measurements in patients undergoing open abdominal aortic anuerysm repair (AAA)(N = 136) or coronary artery bypass grafting (CABG)(N = 2193). The cohorts were stratified in tertiles to assess effects over the different groups. Generalized Linear Models were used to determine associations between RDW and postoperative inflammatory complications. Hematopoietic tissue activity was scored using fluor‐18‐(18F)‐deoxyglucose positron emission tomography and associated with RDW using linear regression models. Results In total, 43(31.6%) and 73 patients (3.3%) suffered from inflammatory complications after AAA‐repair or CABG, respectively; the majority being pneumonia in both cohorts. Postoperative inflammatory outcome incidence increased from 19.6% in the lowest to 48.9% in the highest RDW tertile with a corresponding risk ratio (RR) of 2.35 ([95%CI:1.08‐5.14] P = 0.032) in AAA patients. In the CABG cohort, the incidence of postoperative inflammatory outcomes increased from 1.8% to 5.3% with an adjusted RR of 1.95 ([95%CI:1.02‐3.75] P = 0.044) for the highest RDW tertile compared with the lowest RDW tertile. FDG‐PET scans showed associations of RDW with tissue activity in the spleen (B = 0.517 [P = 0.001]) and the lumbar bone marrow (B = 0.480 [P = 0.004]). Conclusion Elevated RDW associates with increased risk for postoperative inflammatory complications and hematopoietic tissue activity. RDW likely reflects chronic low‐grade inflammation and should be considered to identify patients at risk for postoperative inflammatory complications following cardiovascular surgery.

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Is Endocan a Diagnostic Marker for Pneumonia After Cardiac Surgery? The ENDOLUNG Study

Abstract: This study shows that endocan is an early marker of postoperative pneumonia in patients after cardiac surgery.

Cited by 19 publications

References 31 publications

Endocan, sepsis, pneumonia, and acute respiratory distress syndrome

Endocan, sepsis, pneumonia, and acute respiratory distress syndrome

Postoperative serum levels of Endocan are associated with the duration of norepinephrine support after coronary artery bypass surgery

A single preoperative blood test predicts postoperative sepsis and pneumonia after coronary bypass or open aneurysm surgery

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