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High Endocan Levels Predict the Need for Ventilatory Support Among Patients With Severe Sepsis FREE TO VIEW

Mandeep Mangat, MD; Bravein Amalakuhan, MD; Sheila Habib, MD; Luis Reyes, MD; Antonio Anzueto, MD; Stephanie Levine, MD; Jay Peters, MD; Marcos Restrepo, MD
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University of Texas Health Science Center at San Antonio, San Antonio, TX

Chest. 2015;148(4_MeetingAbstracts):345A. doi:10.1378/chest.2271136
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SESSION TITLE: Sepsis and Shock Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Endocan is a novel biomarker commonly found in lung and kidney endothelial cells. Elevated serum levels are present in diseases such as acute respiratory distress syndrome, pneumonia and sepsis. Hypoxia, through an incompletely described pathway involving hypoxia inducible factor 1, is related with the upregulation of endocan as a result of respiratory failure. The aim of this study was to determine the association between endocan levels and the need for mechanical ventilation among patients with severe sepsis.

METHODS: A secondary analysis of a prospective cohort of adult septic patients with more than one organ failure and not requiring mechanical ventilation upon admission to the ICU were evaluated. Serum endocan levels were drawn within 24-48 hours of ICU admission. The primary outcome was need for mechanical ventilation within 96 hours of ICU admission. Secondary outcomes were mortality and need for vasopressors and/or inotropes.

RESULTS: Thirty-one patients met the study criteria with similarities in demographics and severity of illness between the ventilatory (n=8) and non-ventilatory groups (n=23). High endocan levels were associated with the need for mechanical ventilation within 96 hours of organ failure when compared to lower levels of endocan (median [IQR) 4.9 [2.9, 10.1] vs. 2.4 [2, 2.7]; p = 0.001). Endocan levels had a receiver operating characteristic (ROC) curve value of 0.89 in predicting need for mechanical ventilation. No differences were observed among groups regarding mortality or need for vasopressors and/or inotropes.

CONCLUSIONS: Elevated endocan levels are associated with the need for mechanical ventilation in patients with severe sepsis, but not hospital mortality or need for vasopressors and/or inotropes. Pathophysiological mechanisms linked to hypoxic induced factors may affect endocan levels.

CLINICAL IMPLICATIONS: Elevated endocan levels may predict the need for mechanical ventilation among patients with sepsis.

DISCLOSURE: The following authors have nothing to disclose: Mandeep Mangat, Bravein Amalakuhan, Sheila Habib, Luis Reyes, Antonio Anzueto, Stephanie Levine, Jay Peters, Marcos Restrepo

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