The effect of prostacyclin infusion on markers of endothelial activation and damage in mechanically ventilated patients with SARS-CoV-2 infection.
J Crit Care
; 69: 154010, 2022 06.
Article
in English
| MEDLINE | ID: covidwho-1693300
ABSTRACT
BACKGROUND:
In a pilot study, we found a significant reduction in mean daily sequential organ failure assessment score in mechanically ventilated patients with COVID-19 who received prostacyclin, compared to placebo. We here investigate the effect on biomarkers of endothelial activation and damage.METHODS:
Post-hoc study of a randomized controlled trial in adult patients with confirmed SARS-CoV-2 infection, mechanically ventilated, with soluble thrombomodulin (sTM) plasma levels >4 ng/mL. Patients received prostacyclin infusion (1 ng/kg/min) or placebo. Blood samples were collected at baseline and 24 h.RESULTS:
Eighty patients were randomized (41 prostacyclin, 39 placebo). The median changes in syndecan-1 plasma levels at 24 h were -3.95 (IQR -21.1 to 2.71) ng/mL in the prostacyclin group vs. 3.06 (IQR -8.73 to 20.5) ng/mL in the placebo group (difference of the medians -7.01 [95% CI -22.3 to -0.231] ng/mL, corresponding to -3% [95% CI -11% to 0%], p = 0.04). Changes in plasma levels of sTM, PECAM-1, p-selectin, and CD40L did not differ significantly between groups.CONCLUSIONS:
Prostacyclin infusion, compared to placebo, resulted in a measurable decrease in endothelial glycocalyx shedding (syndecan-1) at 24 h, suggesting a protective effect on the endothelium, which may be related to the observed reduction in organ failure.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Epoprostenol
/
COVID-19
Type of study:
Experimental Studies
/
Prognostic study
/
Randomized controlled trials
Limits:
Adult
/
Humans
Language:
English
Journal:
J Crit Care
Journal subject:
Critical Care
Year:
2022
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS