Vascular endothelial growth factor (VEGF) and its receptor, soluble fms-like tyrosine kinase (sFLT), are biomarkers of endothelial activation. Vascular endothelial growth factor and sFLT have been associated with sepsis severity among adults, but pediatric data are lacking. The goal of this study was to assess VEGF and sFLT as predictors of outcome for children with sepsis. METHODS: Biomarkers measured for each patient at time of presentation to the emergency department were compared in children with septic shock versus children with sepsis without shock. For children with septic shock, the associations between biomarker levels and clinical outcome measures, including intensive care unit and hospital length of stay, vasoactive inotrope score, and measures of organ dysfunction, were assessed. RESULTS: Soluble fms-like tyrosine kinase and VEGF were elevated in children with septic shock (n = 73) compared with those with sepsis (n = 93). Elevated sFLT but not VEGF was associated with longer intensive care unit length of stay (P = 0.003), longer time requiring vasoactive agents (P < 0.001), higher maximum vasoactive inotrope score (P < 0.001), and higher maximum pediatric logistic organ dysfunction score (P < 0.001). CONCLUSIONS: Vascular endothelial growth factor and sFLT measured in the emergency department are elevated in children with septic shock, and elevated sFLT but not VEGF is associated with worse clinical outcomes.
Vascular endothelial growth factor (VEGF) and its receptor, soluble fms-like tyrosine kinase (sFLT), are biomarkers of endothelial activation. Vascular endothelial growth factor and sFLT have been associated with sepsis severity among adults, but pediatric data are lacking. The goal of this study was to assess VEGF and sFLT as predictors of outcome for children with sepsis. METHODS: Biomarkers measured for each patient at time of presentation to the emergency department were compared in children with septic shock versus children with sepsis without shock. For children with septic shock, the associations between biomarker levels and clinical outcome measures, including intensive care unit and hospital length of stay, vasoactive inotrope score, and measures of organ dysfunction, were assessed. RESULTS: Soluble fms-like tyrosine kinase and VEGF were elevated in children with septic shock (n = 73) compared with those with sepsis (n = 93). Elevated sFLT but not VEGF was associated with longer intensive care unit length of stay (P = 0.003), longer time requiring vasoactive agents (P < 0.001), higher maximum vasoactive inotrope score (P < 0.001), and higher maximum pediatric logistic organ dysfunction score (P < 0.001). CONCLUSIONS: Vascular endothelial growth factor and sFLT measured in the emergency department are elevated in children with septic shock, and elevated sFLT but not VEGF is associated with worse clinical outcomes.
Authors: Jane E Whitney; Rui Feng; Natalka Koterba; Fang Chen; Jenny Bush; Kathryn Graham; Simon F Lacey; Jan Joseph Melenhorst; Samir M Parikh; Scott L Weiss; Nadir Yehya Journal: Crit Care Explor Date: 2020-12-04
Authors: Jinqing Li; Huazhong Zhou; Bing Wei; Di Che; Yufen Xu; Lei Pi; Lanyan Fu; Jie Hong; Xiaoqiong Gu Journal: Front Public Health Date: 2022-07-13
Authors: Jane E Whitney; Binqing Zhang; Natalka Koterba; Fang Chen; Jenny Bush; Kathryn Graham; Simon F Lacey; Jan Joseph Melenhorst; David T Teachey; Janell L Mensinger; Nadir Yehya; Scott L Weiss Journal: Crit Care Med Date: 2020-03 Impact factor: 7.598
Authors: Hector Gonzalez; Colm Keane; Claire H Masterson; Shahd Horie; Stephen J Elliman; Brendan D Higgins; Michael Scully; John G Laffey; Daniel O'Toole Journal: Int J Mol Sci Date: 2020-11-04 Impact factor: 5.923