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Παρασκευή 23 Φεβρουαρίου 2018

Endothelial Cell-Specific Molecule-1 in Critically Ill Patients With Hematologic Malignancy

imageObjectives: To assess whether serum concentration of endothelial cell-specific molecule-1 (Endocan) at ICU admission is associated with the use of ICU resources and outcomes in critically ill hematology patients. Design: Prospective multicenter cohort study. Setting: Seventeen ICUs in France and Belgium. Patients: Seven hundred forty-four consecutive critically ill hematology patients; 72 critically ill septic patients without hematologic malignancy; 276 healthy subjects. Intervention: None. Measurements and Main Results: Median total endocan concentrations were 4.46 (2.7–7.8) ng/mL. Endocan concentrations were higher in patients who had received chemotherapy before ICU admission (4.7 [2.8–8.1] ng/mL vs. 3.7 [2.5–6.3] ng/mL [p = 0.002]). In patients with acute respiratory failure, endocan levels were increased in patients with drug-induced pulmonary toxicity compared with other etiologies (p = 0.038). Total endocan levels higher than 4.46 ng/mL were associated with a higher cumulative probability of renal replacement therapy requirement (p = 0.006), a higher requirement of mechanical ventilation (p = 0.01) and a higher requirement of vasopressors throughout ICU stay (p

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