Introduction: Cytokines activate endothelium and induce expression of cell adhesion molecules in vitro. Soluble endothelial selectin(E-sel), vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1) are markers of endothelial activation and are increased in the serum of sepsis patients. If endothelium is central to inflammation-induced MOF in sepsis, then sCAM levels should be increased in children who develop persistent MOF (PMOF). We hypothesized that children with sepsis and PMOF would have greater sCAM than those with resolved MOF (RMOF) or no MOF (NMOF).

Methods: An organ failure index (OFI= 1 point for organ failure) was given to 73 pediatric sepsis patients on days 1, 2, and 3 of sepsis. PMOF(n= 19) had OFI ≥ 3 on day 3, RMOF (n= 25) had OFI ≥ 3 on day 1 or 2 but< 3 on day 3, and NMOF (n= 29) had OFI < 3 on days 1, 2, and 3. Plasma E-sel, ICAM-1, and VCAM-1 were measured (ELISA) on days 1 and 3 of sepsis. Data were compared by two-way ANOVA.

Results: See Table. Values are mean(± SEM) ng/ml. E-sel (PMOF vs RMOF vs NMOF; NS). ICAM-1 (PMOF > RMOF and NMOF; p <0.05). VCAM-1 (PMOF> RMOF and NMOF; p < 0.05). E-sel, ICAM-1, and VCAM-1 did not differ within groups from day 1 to day 3.

Table 1
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Conclusions: Serum ICAM-1 and VCAM-1 are increased in PMOF compared to RMOF and NMOF. We speculate that ICAM-1 and VCAM-1, involved in leukocyte transmigration, may be markers of ongoing endothelium-mediated organ damage in PMOF.