Rapid assay for plasma soluble E-selectin predicts the development of acute respiratory distress syndrome in patients with systemic inflammatory response syndrome.

A newly developed rapid immunoassay method for plasma soluble E-selectin (sES) was examined to determine whether it can predict the development of acute respiratory distress syndrome (ARDS) in critically ill patients with systemic inflammatory response syndrome (SIRS). Plasma levels of sES were measured on admission (day 1) to the emergency unit. Development of various types of organ failures including ARDS was compared in the first 5 days of admission (from day 1 to day 5) between patients with normal plasma levels of sES and those with elevated plasma levels of sES. Plasma levels of sES were determined using a newly developed latex agglutination method that takes 20 min to obtain the test 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(A)E group) and 28 showed normal sES levels (D(A)N group). Development of ARDS was significantly higher in the D(A)E group (15/22, 68.2%) than in the D(A)N 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(A)E group than in the D(A)N group. The mortality rate at 28 days after admission was higher in the D(A)E group (27.3%) than in the D(A)N group (0%) (P < 0.05). Determination of sES levels by this new rapid assay method might be useful for prediction of the development of ARDS in critically ill patients with SIRS, a pathologic condition that has the potential risk for development of multiple organ failure.