Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2021; 9(32): 9731-9740
Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9731
Correlation between circulating endothelial cell level and acute respiratory distress syndrome in postoperative patients
Min Peng, Qing-He Yan, Ying Gao, Zhen Zhang, Ying Zhang, Yi-Feng Wang, He-Ning Wu
Min Peng, Qing-He Yan, Ying Gao, Zhen Zhang, Ying Zhang, Yi-Feng Wang, He-Ning Wu, Department of Intensive Care Unit, Tianjin Medical University General Hospital, Tianjin 300070, China
Author contributions: Peng M conceived and coordinated the study, designed, performed, and analyzed the experiments, and wrote the article; Yan QH and Gao Y carried out the data collection; Zhang Z, Zhang Y, Wang YF and Wu HN performed the data analysis; All authors reviewed the results and approved the final version of manuscript.
Supported by Science and Technology Development Fund Program of Higher Education of Tianjin, No. 20120121.
Institutional review board statement: The study was approved by the Ethics Committees of Tianjin Medical University General Hospital (No. IRB2014-YX-002).
Informed consent statement: All patients signed the informed consent form.
Conflict-of-interest statement: All authors declare that they have no competing interests.
Data sharing statement: Not applicable.
STROBE statement: The manuscript was checked according to the STROBE.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Peng, MD, Chief Physician, Department of Intensive Care Unit, Tianjin Medical University General Hospital, No. 154 Anshan Street, Heping District, Tianjin 300070, China. pengmin2021@sina.com
Received: June 30, 2021
Peer-review started: June 30, 2021
First decision: July 26, 2021
Revised: August 27, 2021
Accepted: September 24, 2021
Article in press: September 24, 2021
Published online: November 16, 2021
ARTICLE HIGHLIGHTS
Research background

Acute respiratory distress syndrome (ARDS) involves alveolar epithelial cells and pulmonary interstitial capillary endothelial cells. Circulating endothelial cells (CECs) are the only marker that directly reflects vascular endothelial injury in vivo. There have been few studies on the correlation between peripheral blood CECs and ARDS at home and abroad.

Research motivation

This research studied correlation between level of CECs and severity of ARDS, and preliminarily observed change trend of CECs at different time points. This is believed to be initiated research to compare CECs levels changes in patients with ARDS, and it had value of guiding treatment and evaluating prognosis for ARDS patients.

Research objectives

This study aimed to explore the correlation between CEC level and severity of ARDS in patients postoperatively.

Research methods

Blood samples were collected from all patients on day 2 (d2) and day 5 (d5) after surgery. Number of CECs was measured by flow cytometry, and operation time was recorded. Changes in various indexes of patients were monitored, and diagnosis of ARDS was determined based on ARDS Berlin definition.

Research results

The number of d2 CECs in the ARDS group was significantly higher than that in the healthy control group. The number of d2 CECs in the ARDS group was significantly higher than that in the non-ARDS group. The number of d2 CECs in the non-ARDS group was significantly higher than that in the healthy control group. There was no significant difference in number of d2 CECs between patients with mild and moderate ARDS. The number of d2 CECs in patients with severe ARDS was significantly higher than that in patients with mild and moderate ARDS. The number of d5 CECs was higher than the number of d2 CECs in the ARDS deceased group.

Research conclusions

Changes in number of CECs might predict occurrence and adverse outcome of ARDS postoperatively, and higher numbers of CECs are associated with worse prognosis of ARDS.

Research perspectives

In future experiments, we need to further expand sample size by collecting more enrolled patients, refining grouping, and conducting hierarchical analysis. If one special group of patients was dynamically tracked for detection, this would increase the refinement of CECs detection time points for better observation of dynamic changes of CECs.