Endothelin-1 levels in severe burn injuries

Hypothesis: Most investigators have reported high levels of endothelin (ET) -1 in patients with thermal injury. We attempted to examine the hypothesis that ET-1 levels increase in patients with severe burn injury. Patients and Methods: Plasma from 28 adult subjects, 14 of whom had thermal injuries with a median (range) percentage of total burn surface area of 22 % (20%-76%), was assessed for ET-1 and tumor necrosis factor (TNF) alpha. S amples from closely age-matched patients were obtained on admission (day 1) and 24 hours postinjury (day 2). Samples were obtained before blood transf usion or surgical treatment occurred. Enzyme immunoassay techniques suitabl e for the measurements of the cytokines were used. Results: Median (range) of TNF-alpha was higher in patients (day 1, 10.0 ng /L [1.2-35.0 ng/L]; day 2, 12.0 ng/L [0.4-39.0 ng/L]) than controls (0.8 ng /L [0.3-3.2 ng/L]) (P<.005) while ET-1 levels remained significantly unchan ged in patients (mean [SD], day 1, 183.0 [42.2] ng/L; day 2, 204.7 [41.7] n g/L) compared with controls (170.0 [59.8] ng/L) (P>.05). Conclusions: We observed no significantly raised levels of ET-1 in patients with thermal injury within 24 hours after burn injury. We found no signifi cant correlation between the plasma levels of TNF-alpha and ET-1. Endotheli n-1 levels did not seem to reflect severity of illness. The actual evaluati on of ET-1 release in patients with thermal injury could enhance the pathop hysiological study of human thermal injury.