Newly developed plasma soluble E-selectin rapid assay predicts prevalence of acute respiratory distress syndrome in critically ill patients

Background

Plasma levels of soluble E-selectin (sES) have been shown to reflect the production of TNF, a proinflammatory cytokine critically involved in the pathogenesis of various types of organ failure in sepsis. We examined whether a newly developed rapid immunoassay method for plasma sES is able to predict the prevalence of organ failure including acute respiratory distress syndrome (ARDS) in critically ill patients.

Methods

Plasma samples were obtained from 50 critically ill patients showing systemic inflammatory response syndrome (SIRS) on admission to the emergency unit. Plasma levels of sES were determined using a latex agglutination method.

Results

The normal range of the plasma sES level was 4.8–29.7 ng/ml with this method. Among the patients examined, 22 patients showed elevated sES levels (D_AE group) and 28 patients normal sES levels (D_AN group). The prevalence of ARDS was significantly higher in the D_AE group (15/22, 68.2%) than in the D_AN group (4/28, 14.3%) (P < 0.001) and that of cardiovascular system failure, renal failure, and coagulation system failure was also significantly higher in the D_AE group than in the D_AN group in the first 5 days after admission. The mortality rate at 28 days after admission was significantly higher in the D_AE group (27.3%) than in the D_AN group (0%) (P < 0.05).

Conclusion

Determination of sES levels by this new rapid assay method might be useful for prediction of the prevalence of organ failure including ARDS and the outcome in critically ill patients showing SIRS, a pathologic condition that has the potential risk for development of multiple organ failure.