Usefulness of soluble E-selectin in the clinicopathologic assessment of acute lung injury/acute respiratory distress syndrome

Introduction

A retrospective observational study was conducted to evaluate whether the plasma level of soluble E-selectin [1] might be a specific pathologic marker of acute lung injury/acute respiratory distress syndrome (ALI/ARDS).

Methods

The data of 52 critically ill patients admitted to the ICU with systemic inflammatory response syndrome and initiated on mechanical ventilation were retrospectively evaluated.

Results

The plasma levels of soluble E-selectin determined within 24 hours of admission were significantly correlated with the Sequential Organ Failure Assessment scores determined within 24 hours of admission. Furthermore, the scores for both respiratory failure (evaluated by the PaO₂/FiO₂ ratio) and liver dysfunction (evaluated by the serum bilirubin value) in the Sequential Organ Failure Assessment scoring system were significantly correlated with plasma levels of soluble E-selectin. In relation to respiratory failure, the plasma level of soluble E-selectin was higher in patients with ALI/ARDS than in those without (Figure 1), and receiver operating characteristic analysis revealed that this parameter might be a specific marker of ALI/ARDS (Figure 2).

Figure 1

Soluble E-selectin values in patients with non-ALI/ARDS, ALI or ARDS.

Figure 2

Receiver operating characteristic curves of soluble E-selectin. CRP, C-reactive protein; WBC, white blood cell count; E-XDP, elastase digests of cross-linked fibrin.

Conclusion

Soluble E-selectin might be specific and useful marker for the clinicopathologic assessment of ALI/ARDS in critically ill patients with systemic inflammatory response syndrome. However, further investigation is clearly needed to determine whether soluble E-selectin can indeed predict the development of ALI/ARDS.