ABSTRACT
Objective To assess the diagnostic and prognostic value of measuring presepsin in patients with acute respiratory distress syndrome (ARDS).Methods Plasma prsepsin was collected from 81 patients with ARDS,27 patients with cardiogenic pulmonary edema (CPE) and 20 healthy volunteers at enrollment.Levels of presepsin were measured using the PATHFAST(R) analysis system based on a chemiluminescent enzyme immunoassay (CLEIA).The differences of plasma prsepsin were compared between different groups.The 28-day mortality were followed in ARDS patients,and the characteristics of the surviors and non-surviors were compared.Results ARDS patients had significantly higher median levels of presepsin compared to CPE patients [926.89 (485.41-2 662.32)pg/mL vs.376.21 (247.16-568.52) pg/mL,P＜0.001] at enrollment.The difference between infected and non-infected ARDS patients did not showed statistical significance [(934.74 (456.44-3 322.51) pg/mL vs.798.12 (485.41-2 561.40) pg/mL,P--0.079).In ARDS patients,the presepsin levels of non-survivors was significantly higher than that of survivors [3 158.3 (963.91-4 489.33) pg/mL vs.729.09 (398.05-1 467.24) pg/mL,P＜0.001],and multivariate Logistic regression showed that presepsin (OR =1.51,P =0.027) was the independent predictor for 28-day mortality in ARDS patients with acute lung injury (ALI).Conclusions Presepsin was an effective indicator in diagnosing ARDS,and it also was a strong prognostic marker for short-term mortality in ARDS.
ABSTRACT
Objective To investigate the diagnostic and prognostic value of plasma soluble CD163 (sCD163) levels in patients with acute respiratory distress syndrome (ARDS).Methods A total of 124 individuals,83 patients with ARDS,20 patients with cardiogenic pulmonary edema (CPE),and 21 healthy controls,were enrolled in this study.ARDS patients were classified into survivors and nonsurvivors according to 28-day mortality.The concentration of plasma sCD163 was measured by enzymelinked immunosorbent assay (ELISA).Receiver operating characteristic (ROC) curves were employed to evaluate the accuracy of sCD163 in diagnosing ARDS and predicting 28-day ICU outcome.Cumulative survival curve was carried out by Kaplan-Meier survival analysis.Logistic regression analysis was assessed by univariate and multivariate analysis to identify independent predictors of outcome controlling for reported risk factor of mortality.Results Patients with ARDS had significantly higher median levels of sCD163 compared to patients with CPE [496.7(421.8-577.5) ng/mL vs.284.5(141.7-459.2) ng/mL,P＜0.001] upon admission to ICU.The sCD163 levels of non-survivors was significantly higher than that of survivors [577.5 (503.7-623.4) ng/mL vs.479.6 (395.4-520.8) ng/mL,P＜0.001].Multivariate logistic regression showed sCD163 (OR =1.02,P =0.001)was the independent predictor for 28-day mortality in patients with ARDS.Conclusions Plasma sCD163 is a potential biomarker for diagnosis of ARDS and differenting the severity of ARDS.Meanwhile,sCD163 was an independent prognostic marker for 28-day mortality in ARDS patients.