Your browser doesn't support javascript.
Soluble Suppression of Tumorigenicity-2 Associates With Ventilator Dependence in Coronavirus Disease 2019 Respiratory Failure.
Alladina, Jehan W; Giacona, Francesca L; White, Emma B; Brait, Kelsey L; Abe, Elizabeth A; Michelhaugh, Sam A; Hibbert, Kathryn A; Januzzi, James L; Thompson, B Taylor; Cho, Josalyn L; Medoff, Benjamin D.
  • Alladina JW; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
  • Giacona FL; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
  • White EB; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
  • Brait KL; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
  • Abe EA; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
  • Michelhaugh SA; Division of Cardiology, Massachusetts General Hospital, Boston, MA.
  • Hibbert KA; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
  • Januzzi JL; Division of Cardiology, Massachusetts General Hospital, Boston, MA.
  • Thompson BT; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
  • Cho JL; Division of Pulmonary, Critical Care, and Occupational Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.
  • Medoff BD; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
Crit Care Explor ; 3(7): e0480, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1301384
ABSTRACT

OBJECTIVES:

We hypothesize that elevated soluble suppression of tumorigenicity-2 concentrations, a marker of pulmonary epithelial injury, reflect ongoing lung injury in acute hypoxemic respiratory failure due to coronavirus disease 2019 and associate with continued ventilator dependence.

DESIGN:

We associated serial plasma soluble suppression of tumorigenicity-2 levels and markers of systemic inflammation including d-dimer, C-reactive protein, and erythrocyte sedimentation rate with 30-day mortality and ventilator dependence.

SETTING:

Adult medical ICUs and general medicine wards at an academic teaching hospital in Boston, MA. PATIENTS Adult patients with severe acute respiratory syndrome coronavirus 2 infection and acute hypoxemic respiratory failure admitted to the ICU (n = 72) and non-ICU patients managed with supplemental oxygen (n = 77).

INTERVENTIONS:

Observational study from April 25 to June 25, 2020. MEASUREMENTS AND MAIN

RESULTS:

ICU patients had a higher baseline body mass index and median soluble suppression of tumorigenicity-2, d-dimer, and C-reactive protein concentrations compared with non-ICU patients. Among ICU patients, elevated baseline modified Sequential Organ Failure Assessment score and log (soluble suppression of tumorigenicity-2) were associated with 30-day mortality, whereas initial Pao2/Fio2 and markers of systemic inflammation were similar between groups. Only log (soluble suppression of tumorigenicity-2) associated with ventilator dependence over time, with the last measured log (soluble suppression of tumorigenicity-2) concentration obtained on ICU day 11.5 (interquartile range [7-17]) higher in patients who required reintubation or tracheostomy placement compared with patients who were successfully extubated (2.10 [1.89-2.26] vs 1.87 ng/mL [1.72-2.13 ng/mL]; p = 0.03). Last measured systemic inflammatory markers, modified Sequential Organ Failure Assessment score, and Pao2/Fio2 were not different between patients who were successfully extubated compared with those with continued ventilator dependence.

CONCLUSIONS:

Plasma soluble suppression of tumorigenicity-2 is a biomarker readily measured in blood that can provide dynamic information about the degree of a patient's lung injury and real-time assessment of the likelihood of extubation success. Measures of systemic inflammation, illness severity, and oxygenation did not associate with ventilator outcomes.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Randomized controlled trials / Risk factors Language: English Journal: Crit Care Explor Year: 2021 Document Type: Article Affiliation country: CCE.0000000000000480

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Randomized controlled trials / Risk factors Language: English Journal: Crit Care Explor Year: 2021 Document Type: Article Affiliation country: CCE.0000000000000480