acute, potent and generalized activation of the immune and hemostatic
system . This may result in extensive inflammation and
vascular thrombosis, a microcirculatory disorder that has as a consequence
the disruption of smooth blood flow and hence oxygen
toward the cells .
Despite the significant progress of the last decades in the investigation
of sepsis mechanisms, mortality due to severe sepsis
remains high. Recent data pinpoint endothelial dysfunction as a
very important pathogenetic factor [8]. Endothelial activation often
precedes endothelial dysfunction, and a large number of endothelial
cell (EC) active molecules have been investigated as potential biomarkers
for the early diagnosis and prognostication of sepsis [9].
These biomarkers include regulators of endothelial activation, adhesion
molecules, as well as mediators of permeability, vasomotor
tone, and coagulation [4]. However, as yet there is no generally
acceptable way of either diagnosing endothelial dysfunction at its
early phase or associating the latter with the septic process [10].
The aim of this study was to determine the role of endothelial
biomarkers in the timely diagnosis of sepsis. We evaluated
whether elevated levels of circulating endothelial biomarkers of
critically-ill patients upon admission to the Intensive Care Unit
(ICU) can predict sepsis before it is clinically manifested, so the
appropriate therapeutic handlings can be performed at an early
phase in an effort to achieve optimal treatment.