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The predictive role of serum and bronchoalveolar lavage cytokines and adhesion molecules for acute respiratory distress syndrome development and outcome

Title: The predictive role of serum and bronchoalveolar lavage cytokines and adhesion molecules for acute respiratory distress syndrome development and outcome
Authors: Karkavitsas Nikolaos; Perisinakis Kostas; Prekates Athanasios; Alexandrakis Michael G; Kyriakou Despina; Agouridakis Panagiotis; Bouros Demosthenes
Source: Respiratory Research, Vol 3, Iss 1, p 25 (2002)
Publisher Information: BMC
Publication Year: 2002
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: ARDS; adhesion molecules; BAL; cytokines; survival; Diseases of the respiratory system; RC705-779
Description: Background The predictive role of many cytokines and adhesion molecules has not been studied systematically in acute respiratory distress syndrome (ARDS). Methods We measured prospectively tumour necrosis factor alpha (TNF-α), interleukin (IL)-1, soluble vascular adhesion molecule-1 (VCAM-1) and soluble intercellular adhesion molecule-1 (ICAM-1) in serum and bronchoalveolar lavage fluid (BALF) within 2 hours following admission, in 65 patients. The patients were divided into: those fulfilling the criteria for ARDS ( n = 23, group A), those who were pre-ARDS and who developed ARDS within 24 hours ( n = 14, group B), and those on pre-ARDS but who never developed ARDS ( n = 28, group C). Results All the measured molecules were only found at higher levels in the serum of patients that died either with or without ARDS ( P < 0.05 – P < 0.0001). Patients at risk exhibited a good negative predictive value (NPV) of the measured molecules for ARDS development both in their serum (89 to 95%) and BALF (86 to 92%) levels. In contrast to BALF, serum levels of IL-1 and adhesion molecules exhibited a good NPV (68 to 96%), sensitivity (60 to 88%) and survival specificity (74 to 96%) in all groups. All molecules in serum and BALF IL-1 were correlated with the APACHE II ( P < 0.05 – P < 0.0001). Serum and BALF IL-1 as well as BALF TNF-α were negatively correlated to PaO 2 /FiO 2 (all P < 0.05). Conclusions The studied molecules have good NPV for ARDS development both in serum and BALF. Serum rather than BALF levels seem to be related to outcome.
Document Type: article in journal/newspaper
Language: English
Relation: http://dx.doi.org/10.1186/rr193; https://doaj.org/toc/1465-9921; https://doaj.org/article/adc472e31bfa4b38ab080eb0c2306904
DOI: 10.1186/rr193
Availability: https://doi.org/10.1186/rr193; https://doaj.org/article/adc472e31bfa4b38ab080eb0c2306904
Accession Number: edsbas.2978279C
Database: BASE