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Disease Markers
Volume 2017, Article ID 6758721, 6 pages
https://doi.org/10.1155/2017/6758721
Research Article

Angiopoietin-2 Levels as Predictors of Outcome in Mechanically Ventilated Patients with Acute Respiratory Distress Syndrome

1Second Department of Critical Care Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
2Laboratory of Hematology & Blood Bank Unit, Medical School, National and Kapodistrian University of Athens, Athens, Greece
34th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
4Department of Biochemistry, Athens University Hospital Attikon, Medical School, National and Kapodistrian University of Athens, Athens, Greece

Correspondence should be addressed to Iraklis Tsangaris; rg.aou.dem@sirakgasti

Received 16 February 2017; Revised 6 June 2017; Accepted 4 July 2017; Published 29 August 2017

Academic Editor: Michael Hawkes

Copyright © 2017 Iraklis Tsangaris et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pulmonary endothelium dysfunction is a key characteristic of ARDS. The aim of this study was to investigate endothelium-derived markers, such as angiopoietin-2 (Ang-2) and endothelial cell-specific molecule-1 (endocan), at the vascular and alveolar compartments as outcome predictors in ARDS. Fifty-three consecutive ARDS patients were studied. The primary outcome was 28-day mortality. Secondary endpoints were days of unassisted ventilation and days with organ failure other than ARDS, during the 28-day study period. Nonsurvivors presented higher lung injury scores and epithelial lining fluid (ELF) Ang-2 levels compared to survivors, with no significant differences in plasma Ang-2, endocan, and protein C concentrations between the two groups. In logistic regression analysis, ELF Ang-2 levels > 705 pg/ml were the only independent variable for 28-day mortality among the previous four. Plasma endocan values > 13 ng/pg were the only parameter predictive against days of unassisted ventilation during the 28-day study period. Finally, lung injury score > 2.25 and ELF Ang-2 levels > 705 pg/ml were associated with increased number of days with organ failure, other than ARDS. Our findings suggest that Ang-2 levels are increased in the alveolar compartment of ARDS patients, and this may be associated both with increased mortality and organ failure besides lung.