Assessment of Vascular Endothelial Dysfunction in Septic Patients Using Brachial Flow-Mediated Dilation: A Systematic...

Area of Science:

• Cardiovascular Physiology
• Critical Care Medicine
• Vascular Biology

Background:

• Sepsis is a leading cause of global mortality, necessitating early risk stratification and prognosis.
• Endothelial dysfunction is a key feature of sepsis, potentially preceding organ failure.
• Brachial flow-mediated dilation (FMD) quantifies endothelium-dependent vasodilation and reflects endothelial function.

Purpose of the Study:

• To systematically review and meta-analyze the evidence on FMD's validity for assessing vascular endothelial dysfunction in sepsis.
• To compare FMD between septic patients and non-septic controls.
• To compare FMD between sepsis survivors and non-survivors.

Main Methods:

• Systematic literature search of PubMed, Embase, Scopus, and Web of Science up to November 2024.
• Inclusion of clinical studies measuring FMD in septic patients.
• Random-effects model meta-analysis and Newcastle-Ottawa Scale for quality assessment.

Main Results:

• Eight studies were included, with seven undergoing quantitative synthesis (385 septic patients).
• Septic patients exhibited significantly lower FMD compared to non-septic controls (SMD = -2.1617, p=0.0113).
• Sepsis non-survivors showed significantly lower FMD than survivors (SMD = -0.7003, p=0.001).

Conclusions:

• Lower FMD in septic patients suggests potential as a surrogate marker for endothelial dysfunction.
• Attenuated FMD in non-survivors indicates its utility in sepsis prognosis and risk assessment.
• FMD measurement offers a noninvasive approach to evaluating vascular health in sepsis.