{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:08:10Z","timestamp":1789168090936,"version":"build-2803163510"},"reference-count":53,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Qatar University Internal Grant","award":["QUCG-CPH-25\/26-754"],"award-info":[{"award-number":["QUCG-CPH-25\/26-754"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objective: Sepsis remains a major cause of morbidity and mortality worldwide, making early risk stratification and prognosis critical. Vascular endothelial dysfunction is a hallmark of sepsis pathogenesis, with evidence suggesting that endothelial injury may occur early, preceding organ failure. Brachial flow-mediated dilation (FMD), a validated noninvasive ultrasound technique measuring endothelium-dependent vasodilation, serves as a surrogate marker of endothelial function, where lower FMD values reflect impaired function. This systematic review and meta-analysis aimed to evaluate the validity and quality of evidence on using FMD to measure vascular endothelial dysfunction in septic patients by comparing FMD (i) between septic patients and non-septic controls and (ii) between sepsis non-survivors and survivors. Methods: PubMed, Embase, Scopus, and Web of Science were searched until November 2024 for clinical studies assessing FMD in septic patients. A random-effects model was used for the meta-analysis, and quality of studies was assessed using the Newcastle\u2013Ottawa Scale. Results: Eight studies were included, and seven underwent quantitative synthesis (385 septic patients, 106 non-survivors and 217 survivors). Compared with non-septic controls, septic patients demonstrated significantly lower FMD (pooled standardized mean difference (SMD) = \u22122.1617; 95% CI \u22123.8349 to \u22120.4885; p = 0.0113; I2 = 98.2939%). Within the sepsis cohort, non-survivors showed significantly attenuated FMD compared to survivors (pooled SMD = \u22120.7003; 95% CI \u22121.1133 to \u22120.2873; p = 0.001; I2 = 60.5593%). Conclusions: FMD shows potential as a surrogate marker of endothelial dysfunction for sepsis risk assessment, as evident by lower FMD in septic patients, particularly non-survivors.<\/jats:p>","DOI":"10.3390\/diagnostics15233021","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T11:50:13Z","timestamp":1764244213000},"page":"3021","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessment of Vascular Endothelial Dysfunction in Septic Patients Using Brachial Flow-Mediated Dilation: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7859-8490","authenticated-orcid":false,"given":"Lana","family":"Kattan","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Abulola","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed H.","family":"Elsayed","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abderrezzaq","family":"Soltani","sequence":"additional","affiliation":[{"name":"QU Health, Qatar University, Doha P.O. Box 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9757-3574","authenticated-orcid":false,"given":"Mohamed Izham","family":"Mohamed Ibrahim","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0276-9916","authenticated-orcid":false,"given":"Zaid H.","family":"Maayah","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990\u20132017: Analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1056\/NEJMp1707170","article-title":"Recognizing sepsis as a global health priority\u2014A WHO resolution","volume":"377","author":"Reinhart","year":"2017","journal-title":"N. Engl. J. 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