Endocan Levels In Peripheral Blood Diagnose And Predict Outcomes Of Acute Respiratory Distress Syndrome

BackgroundAcute respiratory distress syndrome (ARDS) is a common clinicalsyndrome in the ICU that is under diagnosed. Endocan is a microvascularendothelial cell-associated protein secreted from the lungs and kidneys thatprevents inflammatory cells from damaging lung tissues. Endocandeficiency may correlate with the severity and outcome of ARDS.Therefore, we performed this study to test whether endocan has thediagnostic and prognostic utility in patients with ARDS.MethodsPlasma samples were obtained from the Respiratory Intensive CareUnit (RICU) and the Center ICU in Second Affiliated Hospital and FirstAffiliated Hospital of Chongqing Medical University andXinqiaoHospital.Plasma endocan levels were measured by sandwichenzyme-linked immunosorbent assay.ResultsWhen compared with44pneumonia patients, patients with ARDS hadhigher median endocan levels in the plasma (median (IQR)3.26(2.50-5.07)vs2.45(2.23-2.79) ng/mL, P=0.0001). Endocan levels significantlycorrelated with the APACHE II score in the ARDS group (r=0.676,p=0.000,n=42). Of42individuals with ARDS,20(47.6%) were dead, andendocan was significantly higher in non-survivors than survivors (median (IQR)5.01(2.98-8.44) vs3.01(2.36-4.36) ng/mL,p=0.017). According tothe results of the ROC-curve analysis and COX proportional hazardsmodels, endocan can predict mortality of ARDS independently with ahazard ratio of1.374(95%CI,1.150-1.641) and an area of receiveroperator characteristic curve (AUROC) of0.715(p=0.017). Moreover,endocan can predict the multiple organ dysfunction of ARDS.ConclusionsHigh levels of plasma endocan predict the possibility of patients withacute respiratory distress syndrome.when endocan levels≥4.96ng/ml，patient with acute respiratory distress syndrome are more likely to occurmultiple organ dysfunction, especially shock and renal failure, and also thehigher mortality. So we draw a conclusion that endocan is a promisingbiomarker for helping to diagnose and predict disease severity andmortality in patients with ARDS.