학술논문
Early plasma angiopoietin-2 is prognostic for ARDS and mortality among critically ill patients with sepsis
Document Type
article
Author
Carrie M. Rosenberger; Katherine D. Wick; Hanjing Zhuo; Nelson Wu; Yue Chen; Sharookh B. Kapadia; Alessander Guimaraes; Diana Chang; David F. Choy; Hubert Chen; Melicent Peck; Kathryn M. Sullivan; Serena Ke; Alejandra Jauregui; Aleksandra Leligdowicz; Pratik Sinha; Antonio D. Gomez; Kirsten N. Kangelaris; Kevin Delucchi; Kathleen D. Liu; Carolyn S. Calfee; Michael A. Matthay; Carolyn M. Hendrickson
Source
Critical Care, Vol 27, Iss 1, Pp 1-4 (2023)
Subject
Language
English
ISSN
1364-8535
Abstract
Abstract Angiopoietin-2 (Ang-2) is associated with vascular endothelial injury and permeability in the acute respiratory distress syndrome (ARDS) and sepsis. Elevated circulating Ang-2 levels may identify critically ill patients with distinct pathobiology amenable to targeted therapy. We hypothesized that plasma Ang-2 measured shortly after hospitalization among patients with sepsis would be associated with the development of ARDS and poor clinical outcomes. To test this hypothesis, we measured plasma Ang-2 in a cohort of 757 patients with sepsis, including 267 with ARDS, enrolled in the emergency department or early in their ICU course before the COVID-19 pandemic. Multivariable models were used to test the association of Ang-2 with the development of ARDS and 30-day morality. We found that early plasma Ang-2 in sepsis was associated with higher baseline severity of illness, the development of ARDS, and mortality risk. The association between Ang-2 and mortality was strongest among patients with ARDS and sepsis as compared to those with sepsis alone (OR 1.81 vs. 1.52 per log Ang-2 increase). These findings might inform models testing patient risk prediction and strengthen the evidence for Ang-2 as an appealing biomarker for patient selection for novel therapeutic agents to target vascular injury in sepsis and ARDS.