CORRELATION BETWEEN INTERCELLULAR ADHESION MOLECULE-1 WITH D-DIMER, LACTATE LEVEL, AND MORTALITY IN PATIENTS WITH VASODILATORY SHOCK

Abstract

Background and aims: The mortality of vasodilatory shock patients in the ICU is more than 50%. Vasodilatory shock is mostly due to excessive inflammation. Intercellular adhesion molecule (ICAM)-1 is expressed in the response process, playing a role in leukocyte emigration, intracellular signaling, and activation of proinflammatory cascades. We analyzed the relationship between ICAM-1 to D-Dimer levels, lactate levels, mortality, and vasopressor doses in critically ill patients in vasodilatory shock.

Methods: Observational analytic study with cross-sectional design. The data were obtained from patients in the ICU and ER of RSUD Dr. Soetomo Surabaya. Measurement of ICAM-1, D-Dimer, lactate, mortality, and vasopressor dose (norepinephrine) at 1-3 and 24 hours of initial treatment. Data were analyzed using EZR version 1.61.

Results: Twenty of 43 (46.5%) patients died by day 28 of treatment. The Mean Arterial Pressure (MAP) was lower in the non-survivors compared to the survivors and significantly different (p=0.015). Lactate level and vasopressor dose were elevated in the non-survivors (p<0.05). ICAM-1 levels were significantly associated with D-dimer levels (p=0.0001), but not with lactate levels, vasopressor dose, or mortality.

Conclusion: There is an association between ICAM-1 and D-dimer levels. Therefore, a correlation between inflammation and coagulophaty degree in patients with vasodilatory shock is related. Correlation between ICAM-1 levels with indicators of tissue hypoxia (lactate), vasopressor dose, and mortality needs further research.

Keywords: Vasodilatory shock, ICAM-1, D-Dimer, lactate