The Diagnostic and Prognostic Role of Vascular Endothelial Growth Factor C in Sepsis and Septic Shock

Abstract

IntroductionVariations in the expression of vascular endothelial growth factor (VEGF) could be used as a biomarker in critically ill patients with sepsis and septic shock. Inflammation potently upregulates VEGF-C expression via macrophages with an unpredictable response. This study aimed to assess one of the newer biomarkers (VEGF-C) in patients with sepsis or septic shock and its clinical value as a diagnostic and prognostic tool.Material and methodsThe study involved 142 persons divided into three groups. Group A consisted of fifty-eight patients with sepsis; Group B consisted of forty-nine patients diagnosed as having septic shock according to the Sepsis -3 criteria. A control group of thirty-five healthy volunteers comprised Group C. Severity scores, prognostic score and organ dysfunction score, were recorded at the time of enrolment in the study. The analysis included specificity and sensitivity of plasma VEGF-C for diagnosis of septic shock. Circulating plasma VEGF-C levels were correlated with the APACHE II, MODS and severity scores and mortality.ResultsThe mean (SD) plasma VEGF-C levels in septic shock patients (1374(789) pg./m), on vasopressors at the time of admission to the ICU, were significantly higher 1374(789)pg./mL, compared the mean (SD) plasma VEGF-C levels in sepsis patients (934(468) pg./mL); (p = 0.0005, Student’s t-test.) Plasma VEGF-C levels in groups A and B were shown to be significantly correlated with the APACHE II (r = 0.21, p = 0.02; r = 0.45, p = 0.0009) and MODS score (r = 0.29, p = 0.03; r = 0.4, p = 0.003). There was no association between plasma VEGF-C levels and mortality [p = 0.1]. The cut-off value for septic shock was 1010 pg./ml.ConclusionsVEGF-C may be used as a prognostic marker in sepsis and septic shock due to its correlation with APACHE II values and as an early marker to determine the likelihood of developing MODS. It could be used as an early biomarker for diagnosing patients with septic shock.

Is Carboxyhaemoglobin an Effective Bedside Prognostic Tool for Sepsis and Septic Shock Patients?

“…Easy, cost-effective bedside tools that can pinpoint towards the outcome of sepsis and septic shock have been the pinnacle of research for many years, especially since world economy suffered severe headwinds amid weak growth prospects and heightened uncertainties. [ 15 , 16 ]. In a fast-paced society, the need for easy-to-read tests should be considered an appendix of physicians.…”

Prognostic role of elevated VEGF in sepsis: A systematic review and meta-analysis

“…We summarize the general information of the study in Table 1: author, year, country, study design, sample size, assay used, mortality follow-up, and NOS scores. Thirteen high quality studies (Liu et al, 2009;Davis et al, 2010;Yang et al, 2011;Xu et al, 2013;Lin et al, 2015;Amalakuhan et al, 2016;Hou et al, 2017;Patry et al, 2018a;Patry et al, 2018b;Almasy et al, 2020;Li, 2020;Seol et al, 2020;Whitney et al, 2020) and seven medium quality studies (Karlsson et al, 2008;Zhang et al, 2012;Jiang et al, 2014;Tian et al, 2015;Akabawy et al, 2016;Koskela et al, 2017;Xu, 2021) were included, and the scoring details of NOS are shown in Table 2.…”

“…Six studies (Davis et al, 2010;Tian et al, 2015;Akabawy et al, 2016;Amalakuhan et al, 2016;Almasy et al, 2020;Whitney et al, 2020) reported a correlation between VEGF and the severity of sepsis. Due to the good homogeneity between studies (I 2 = 22%, p = 0.26), we used the fixed effect model.…”