Increased circulating thrombomodulin in children with septic shock

Area of Science:

• Pediatric critical care medicine
• Vascular biology
• Sepsis research

Background:

• Septic shock involves microcirculatory dysfunction and endothelial injury.
• Plasma thrombomodulin is a marker of endothelial activation and damage.

Purpose of the Study:

• To investigate elevated plasma thrombomodulin in pediatric septic shock.
• To correlate thrombomodulin levels with organ failure and mortality.

Main Methods:

• Prospective cohort study in a pediatric intensive care unit.
• Enrolled 22 children with septic shock and 10 healthy controls.
• Measured plasma thrombomodulin via ELISA every 6 hours for 72 hours in septic shock patients.

Main Results:

• Septic shock nonsurvivors had significantly higher thrombomodulin (10.6 ng/mL) than survivors (5.5 ng/mL) and controls (3.4 ng/mL).
• Thrombomodulin concentrations increased with the number of organ system failures.
• Both survivor and nonsurvivor septic shock patients had elevated thrombomodulin compared to controls.

Conclusions:

• Elevated plasma thrombomodulin in pediatric septic shock suggests endothelial injury.
• Thrombomodulin levels correlate with the extent of multiple organ system failure.
• Plasma thrombomodulin may serve as a biomarker for endothelial damage severity and organ dysfunction in pediatric septic shock.