Angiopoietin-2, permeability oedema, occurrence and severity of ALI/ARDS in septic and non-septic critically ill patients

Background:Angiopoietin-2 and vascular endothelial growth factor (VEGF) may impair vascular barrier function while angiopoietin-1 may protect it. It was hypothesised that circulating angiopoietin-2 is associated with pulmonary permeability oedema and severity of acute lung injury (ALI)/acute respira...

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Bibliographic Details
Published in:Thorax 2008-10, Vol.63 (10), p.903-909
Main Authors: van der Heijden, M, van Nieuw Amerongen, G P, Koolwijk, P, van Hinsbergh, V W M, Groeneveld, A B J
Format: Article
Language:English
Subjects:
Aged
Angiopoietin-1 - metabolism
Angiopoietin-2 - metabolism
Biological and medical sciences
Blood
Cardiology. Vascular system
Catheters
Critical Illness
Edema
Endothelium
Female
Heart surgery
Humans
Intensive care
Male
Medical sciences
Middle Aged
Permeability
Pneumology
Prospective Studies
Pulmonary arteries
Pulmonary Edema - blood
Respiratory Distress Syndrome, Adult - blood
Sepsis
Sepsis - blood
Vascular endothelial growth factor
Vascular Endothelial Growth Factor A - blood
Vascular surgery
Veins & arteries
Ventilators
von Willebrand Factor - metabolism
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Summary:Background:Angiopoietin-2 and vascular endothelial growth factor (VEGF) may impair vascular barrier function while angiopoietin-1 may protect it. It was hypothesised that circulating angiopoietin-2 is associated with pulmonary permeability oedema and severity of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) during septic or non-septic critical illness.Methods:Plasma levels of angiopoietin-1 and angiopoietin-2 were measured in mechanically ventilated patients (24 with sepsis, 88 without sepsis), together with the pulmonary leak index (PLI) for 67-gallium-labelled transferrin and extravascular lung water (EVLW) by transpulmonary thermal-dye dilution as measures of pulmonary permeability and oedema, respectively. ALI/ARDS was characterised by consensus criteria and the lung injury score (LIS). Plasma VEGF and von Willebrand factor (VWF) levels were assayed.Results:Angiopoietin-2, VWF, PLI, EVLW and LIS were higher in patients with sepsis than in those without sepsis and higher in patients with ALI/ARDS (n = 10/12 in sepsis, n = 19/8 in non-sepsis) than in those without. VEGF was also higher in patients with sepsis than in those without. Patients with high PLI, regardless of EVLW, had higher angiopoietin-2 levels than patients with normal PLI and EVLW. Angiopoietin-2 correlated with the PLI, LIS and VWF levels (minimum r = 0.34, p
ISSN:0040-6376
1468-3296
DOI:10.1136/thx.2007.087387