Elevated Plasma Endothelin-1 Concentrations Are Associated with the Severity of Illness in Patients with Sepsis

TLDR

Plasma endothelin‑1 levels were quantified by radioimmunoassay in 11 septic patients within 24 h of sepsis onset, 15 non‑septic postoperative cardiac patients 24 h after surgery, and 14 healthy volunteers. Septic patients had markedly higher endothelin‑1 concentrations than postoperative or healthy controls, and these levels were inversely related to cardiac index and positively associated with APACHE II scores and creatinine, indicating a link between endothelin‑1, illness severity, and reduced cardiac output.

Abstract

Plasma immunoreactive endothelin-1 concentrations were determined by radioimmunoassay in 11 septic patients during the first 24 hours after the development of the sepsis syndrome in 15 nonseptic postoperative patients studied 24 hours after open heart surgery and in 14 healthy volunteers. Mean endothelin-1 plasma concentrations were significantly (p < 0.001) increased in septic patients (19.9 ± 2.2 pg/mL, mean ± standard error) compared to concentrations found in postoperative cardiac patients (11.9 ± 0.7 pg/mL) or in healthy volunteers (6.1 ± 0.3 pg/mL). In septic patients elevated plasma concentrations of endothelin-1 were inversely correlated with cardiac index (r = −0.80, p < 0.005) and positively correlated the severity of illness as documented by APACHE II score (r = 0.74, p < 0.01) and plasma creatinine levels (r = 0.80, p < 0.005). No such correlations were found in postoperative cardiac patients. These results indicate that endothelin-1 concentrations are correlated with the severity of illness and depression of cardiac output in patients with sepsis.