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The study aimed to evaluate the value of soluble endothelial selectin (sE-selectin) plasma level measurement in predicting acute lung injury (ALI) outcome in children.The study was a prospective, controlled study that involved 50 children with ALI and 50 healthy children as a control. Soluble endothelial selectin and C-reactive protein plasma levels were measured at days 1 and 7 of development of ALI for the patient group and done only once for the control group.Plasma sE-selectin was significantly higher in the patients than the control group (P = .001). Mortality reached 32% of children with ALI. The deceased subgroup had significantly higher plasma sE-selectin levels both at days 1 and 7 than the survived (P = .02 and P < .001 respectively). There was positive correlation between plasma sE-selectin at day 7 with durations of both pediatric intensive care unit and mechanical ventilation. Levels of sE-selectin at days 1 and 7 had significant positive correlation with C-reactive protein level and ALI severity. Soluble endothelial selectin plasma levels of 302 ng/mL at day 7 were the best cutoff value to predict ALI-related deaths.Plasma sE-selectin level served as a good predictor biomarker for both mechanical ventilation duration and the mortality risk in children with ALI.