Prognostic value of vascular endothelial growth factor in sepsis syndrome

Background: Serum vascular endothelial growth factor (VEGF) levels are increased in sepsis. Purpose: To investigate the prognostic value of the serum VEGF level in critically ill septic patients regarding the clinical course and final outcome. Methods: A total of 40 critically ill septic patients were included in a prospective, randomized, single center study. All patients were subjected to the measurement of VEGF levels on admission day (VEGF1) and 48 hours later (VEGF2). CRP levels and Microalbuminuria levels were also measured on admission. APACHE IV and SOFA scores were calculated. Clinical outcome (duration of stay in the ICU, need for MV, need for inotropic/vasopressor support, need for hemodialysis, and survival) was recorded. Results: In relation to healthy subjects, the mean VEGF1&2 levels were significantly higher in the septic patients (142+ 28.98 vs 750.5 + 380.34 and 802.07 + 292.65 ng/l; p= 0.001 and <0.001 respectively). Septic patients who required MV, inotropic/vasopressor support and hemodialysis, and also those who died had significantly higher VEGF1 levels compared to those who didn't require them (p= 0.002, 0.006, 0.008 and 0.001 respectively). VEGF2 level was significantly higher only in those who required inotropic/vasopressor support (p= 0.024). VEGF1 and 2 levels were significantly positively correlated with CRP level, Albumin/Creatinine ratio and APACHE IV score. ROC analysis of the data indicated a sensitivity of 85.15% and a specificity of 92.3% when aVEGF1 level of 410 ng/l was taken as a predictor of ICU mortality. Conclusion: The admission VEGF is a useful marker for the evaluation of septic patients. (C) 2016 The Egyptian College of Critical Care Physicians. Production and hosting by Elsevier B.V.