Relationship between Plasma Endothelin-1 Concentrations and Number of Organ Dysfunctions in Critically Ill Patients

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Endothelin (ET)-1 is potent vasoconstrictor peptide mainly synthesized by and secreted from vascular endothelium, which increases in various pathophysiological states. To elucidate the relationship between ET-1 and multiple organ dysfuncition, we measured plasma ET-1 concentrations, APACHE III score, and number of organ dysfunctions in 46 (ages: 63.5±2.0, years old) critically ill patients. Plasma ET-1 concentrations (11.0±1.0pg·ml-1, mean±SE) in these patients on admission to ICU was significantly (P<0.01) higher than those of healthy subjects (1.5±0.1pg·ml-1) and showed a significant (P<0.01) positive correlation with APACHE III score. Plasma ET-1 concentrations in patients with 3 dysfunctioning organ (n=10, 15.1±2.6pg·ml-1) and in patients with 4 dysfunctioning organ (n=7, 14.9±2.4pg·ml-1) were significantly (P<0.05) higher than those in patients with 1 dysfunctioning orgen (n=16, 7.6±1.3pg·ml-1) and in patients with 2 dysfunctioning organ (n=13, 8.9±1.1pg·ml-1). Plasma ET-1 concentrations in survivors (n=30) were significntly (P<0.01) decreased at discharge from ICU. These findings suggest that endogenous ET-1 is increased in proportion to the severity in critically ill patients and sustained increase in ET-1 is related to number of organ dysfunctions in multiple organ dysfunction syndrome.
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