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Clinical and biological markers for predicting ARDS and outcome in septic patients

2021; Nature Portfolio; Volume: 11; Issue: 1 Linguagem: Inglês

10.1038/s41598-021-02100-w

2045-2322

Jesús Villar, Rubén Herrán‐Monge, Elena González-Higueras, Miryam Prieto-González, Alfonso Ambrós, Aurelio Rodríguez, Arturo Muriel-Bombín, Rosario Solano, Cristina Cuenca-Rubio, Ánxela Vidal, Carlos Flores, Jesús María González‐Martín, M. Isabel García-Laorden, R. Adàlia, G. Sánchez‐Etayo, Alfonso Ambrós, Carmen Martín-Rodríguez, Elena González-Higueras, Rosario Solano, Laura Martínez-García, M. Isabel García-Laorden, Jesús Villar, Jesús María González‐Martín, Aurelio Rodríguez, Ángel Ignacio Lledó Becerra, Luis César Valencia-García, Demetrio Carriedo, Francisco Javier Díaz Domínguez, Ánxela Vidal, José M. Añón, Pablo Millán, Domingo Martínez, Miryam Prieto-González, Cristina Cuenca-Rubio, Ana Isabel García-Sánchez, Braulio Álvarez-Martínez, Perfectino Fernández-Pérez, Efrén Otero-Alvarín, Carlos Flores, Gerardo Aguilar, Nasara Segura, Marina Soro, Rubén Herrán‐Monge, Arturo Muriel-Bombín, Marta M. García-García, Concepción Tarancón, Teresa Álvarez,

Inflammation biomarkers and pathways

Abstract Sepsis is a common cause of acute respiratory distress syndrome (ARDS) associated with a high mortality. A panel of biomarkers (BMs) to identify septic patients at risk for developing ARDS, or at high risk of death, would be of interest for selecting patients for therapeutic trials, which could improve ARDS diagnosis and treatment, and survival chances in sepsis and ARDS. We measured nine protein BMs by ELISA in serum from 232 adult septic patients at diagnosis (152 required invasive mechanical ventilation and 72 had ARDS). A panel including the BMs RAGE, CXCL16 and Ang-2, plus PaO 2 /FiO 2 , was good in predicting ARDS (area under the curve = 0.88 in total septic patients). Best performing panels for ICU death are related to the presence of ARDS, need for invasive mechanical ventilation, and pulmonary/extrapulmonary origin of sepsis. In all cases, the use of BMs improved the prediction by clinical markers. Our study confirms the relevance of RAGE, Ang-2, IL-1RA and SP-D, and is novel supporting the inclusion of CXCL16, in BMs panels for predicting ARDS diagnosis and ARDS and sepsis outcome.