Trial reportChest2017
Endothelial Permeability and Hemostasis in Septic Shock: Results From the ProCESS Trial.
Trial report in Chest, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 60 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Protocolized Care for Early Septic Shock
Endothelial Cell Signaling and Microcirculatory Flow in Severe Sepsis
Who cites it
60 citing papers in PubMed, 1 synthesis or guideline pooled it, 92 citations in OpenAlex.
- Prognostic role of elevated VEGF in sepsis: A systematic review and meta-analysis.Frontiers in physiology · 2022Pooled it
- Diminished plasma levels of GPIb-Frontiers in medicine · 2026Trial
- Elevated Syndecan-1 after Trauma and Risk of Sepsis: A Secondary Analysis of Patients from the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial.Journal of the American College of Surgeons · 2018Trial
- Continuous renal replacement therapy attenuates endothelial injury biomarkers in pediatric sepsis: a prospective cohort study.Renal failure · 2026Observational
- Rethinking Fluid Resuscitation in Septic Shock: A Phase-Adapted, Endothelium-Sparing Approach to Mitigate Capillary Leak.Journal of inflammation research · 2026Article
- Emerging role of nucleic acid aptamers in sepsis-induced coagulopathy: Future perspectives in diagnostics and therapeutics.Annals of intensive care · 2026Review
- Soluble Fms-Like Tyrosine Kinase-1 Associates With Risk of Acute Respiratory Distress Syndrome and Mortality in Sepsis.Critical care explorations · 2025Article
- Oxidative stress in vascular surgical diseases: mechanisms, impacts and therapeutic perspectives.Frontiers in pharmacology · 2025Review
- Article
- Isaridin E Protects against Sepsis by Inhibiting Von Willebrand Factor-Induced Endothelial Hyperpermeability and Platelet-Endothelium Interaction.Marine drugs · 2024Article
- Chemical Adjustment of Fibrinolysis.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Serum from patients with cirrhosis undergoing liver transplantation induces permeability in human pulmonary microvascular endothelial cellsFrontiers in medicine · 2024Article
- EASIX-1year and late mortality after allogeneic stem cell transplantation.Blood advances · 2023Article
- Plasminogen System in the Pathophysiology of Sepsis: Upcoming Biomarkers.International journal of molecular sciences · 2023Review
- Review
- Multi-Omics Endotypes in ICU Sepsis-Induced Immunosuppression.Microorganisms · 2023Review
- Organotypic heterogeneity in microvascular endothelial cell responses in sepsis-a molecular treasure trove and pharmacological Gordian knot.Frontiers in medicine · 2023Review
- Biomarkers of endothelial activation and inflammation in dogs with organ dysfunction secondary to sepsis.Frontiers in veterinary science · 2023Article
- Endothelial dysfunction and immunothrombosis in sepsis.Frontiers in immunology · 2023Review
- Endothelial Damage and the Microcirculation in Critical Illness.Biomedicines · 2022Review
Corrections and comments
- Commented on by
Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundWe studied patients from the Protocolized Care in Early Septic Shock (ProCESS) trial to determine the effects of alternative resuscitation strategies on circulating markers of endothelial cell permeability and hemostasis and the association between biomarkers and mortality.
methodsThis was a prospective study of biomarkers of endothelial cell permeability (vascular endothelial growth factor [VEGF], soluble fms-like tyrosine kinase 1 [sFLT-1], angiopoietin 2 [Ang-2]) and biomarkers of hemostasis (von Willebrand factor [vWF], thrombomodulin [TM], tissue plasminogen activator [tPA] in 605 of the 1,341 ProCESS participants in a derivation cohort and 305 participants in a validation cohort. Analyses assessed (1) the impact of varying resuscitation strategies on biomarker profiles and (2) the association of endothelial biomarkers with 60-day in-hospital mortality. The study was conducted in 31 US EDs in adult patients with septic shock. Patients were randomly assigned to one of three resuscitation strategies. Blood samples were collected at enrollment, at 6 h, and at 24 h.
resultsThere were 116 (19.2%) and 52 (17.0%) deaths in the derivation and validation cohorts, respectively. There was no significant association between treatment strategy and any biomarker levels. Permeability (Ang-2 and sFLT-1) and hemostasis (vWF, TM, tPA) biomarkers were higher and VEGF levels were lower in nonsurvivors (P < .05 for all). At baseline, sFLT-1 had the highest point estimate for mortality discrimination (derivation area under the curve [AUC], 0.74; validation, 0.70), similar to lactate (AUC, 0.74) and Sequential Organ Failure Assessment score (AUC, 0.73). In an analysis including all time points and adjusted for age, presence of cancer, and Charlson comorbidity score, the adjusted AUC for sFLT-1 was 0.80.
conclusionsWe found no relationship between different resuscitation strategies and biomarker profiles in sepsis, but we did find that elevated levels of endothelial cell biomarkers of permeability and hemostasis were associated with increased mortality. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00510835 and NCT00793442; URL: www.clinicaltrials.gov.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.