Endothelin-1 (ET-1) is a useful biomarker for early detection of ventilator-assotiated pneumonia (VAP) in mehanical ventilation children

Objectives: VAP is a severe complication limiting survival children. ET-1 is a peptide produced by pulmonary vascular endothelial cells that play a role in the pathophysiology of lung dysfunction. Whether ET-1 could predict VAP development is unknown. Methods: Transbronchial biopsy specimens and serum and bronchoalveolar lavage were obtained from 23 children with VAP and 24 without VAP. The serum and bronchoalveolar lavage ET-1 concentrations were measured by enzyme-linked immunosorbent assay, and the ET-1 mRNA expression in the transbronchial biopsy specimens was examined using real-time polymerase chain reaction. Results: ET-1 serum concentrations were greater in the patients with VAP (P=0.02); and ET-1 mRNA was significantly in the lung of those with versus those without VAP at 3 and 12 day after start mehanical ventilation (P=0.01). At 3 and 12 days after start mehanical ventilation, the ET-1 concentrations were significantly elevated in the serum (P Conclusions: Elevated serum ET-1 concentrations were predictive of VAP, and the assessment of circulating ET-1 might be beneficial in diagnosing and monitoring VAP.