المؤلفون: Rosenberger, Carrie M, Wick, Katherine D, Zhuo, Hanjing, Wu, Nelson, Chen, Yue, Kapadia, Sharookh B, Guimaraes, Alessander, Chang, Diana, Choy, David F, Chen, Hubert, Peck, Melicent, Sullivan, Kathryn M, Ke, Serena, Jauregui, Alejandra, Leligdowicz, Aleksandra, Sinha, Pratik, Gomez, Antonio D, Kangelaris, Kirsten N, Delucchi, Kevin, Liu, Kathleen D, Calfee, Carolyn S, Matthay, Michael A, Hendrickson, Carolyn M

المصدر: Critical care (London, England). 27(1)

مصطلحات موضوعية: Humans, Sepsis, Critical Illness, Angiopoietin-2, Prognosis, Pandemics, Respiratory Distress Syndrome, COVID-19, Clinical Research, Infectious Diseases, Hematology, Lung, Acute Respiratory Distress Syndrome, Rare Diseases, 4.1 Discovery and preclinical testing of markers and technologies, 2.1 Biological and endogenous factors, Detection, screening and diagnosis, Aetiology, Inflammatory and immune system, Good Health and Well Being, Medical and Health Sciences, Emergency & Critical Care Medicine

الوصف: Angiopoietin-2 (Ang-2) is associated with vascular endothelial injury and permeability in the acute respiratory distress syndrome (ARDS) and sepsis. Elevated circulating Ang-2 levels may identify critically ill patients with distinct pathobiology amenable to targeted therapy. We hypothesized that plasma Ang-2 measured shortly after hospitalization among patients with sepsis would be associated with the development of ARDS and poor clinical outcomes. To test this hypothesis, we measured plasma Ang-2 in a cohort of 757 patients with sepsis, including 267 with ARDS, enrolled in the emergency department or early in their ICU course before the COVID-19 pandemic. Multivariable models were used to test the association of Ang-2 with the development of ARDS and 30-day morality. We found that early plasma Ang-2 in sepsis was associated with higher baseline severity of illness, the development of ARDS, and mortality risk. The association between Ang-2 and mortality was strongest among patients with ARDS and sepsis as compared to those with sepsis alone (OR 1.81 vs. 1.52 per log Ang-2 increase). These findings might inform models testing patient risk prediction and strengthen the evidence for Ang-2 as an appealing biomarker for patient selection for novel therapeutic agents to target vascular injury in sepsis and ARDS.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/1mh771fsTest

المؤلفون: Auriemma, Catherine L, Zhuo, Hanjing, Delucchi, Kevin, Deiss, Thomas, Liu, Tom, Jauregui, Alejandra, Ke, Serena, Vessel, Kathryn, Lippi, Matthew, Seeley, Eric, Kangelaris, Kirsten N, Gomez, Antonio, Hendrickson, Carolyn, Liu, Kathleen D, Matthay, Michael A, Ware, Lorraine B, Calfee, Carolyn S

المصدر: Intensive Care Medicine. 46(6)

مصطلحات موضوعية: Acute Respiratory Distress Syndrome, Sepsis, Clinical Research, Infectious Diseases, Patient Safety, Rare Diseases, Hematology, Lung, Detection, screening and diagnosis, 4.1 Discovery and preclinical testing of markers and technologies, Respiratory, Good Health and Well Being, Berlin, Critical Illness, Hospital Mortality, Humans, Intensive Care Units, Prospective Studies, Respiratory Distress Syndrome, Acute respiratory distress syndrome, Acute lung injury, Mortality, Clinical Sciences, Public Health and Health Services, Emergency & Critical Care Medicine

الوصف: PurposePrevious studies assessing impact of acute respiratory distress syndrome (ARDS) on mortality have shown conflicting results. We sought to assess the independent association of ARDS with in-hospital mortality among intensive care unit (ICU) patients with sepsis.MethodsWe studied two prospective sepsis cohorts drawn from the Early Assessment of Renal and Lung Injury (EARLI; n = 474) and Validating Acute Lung Injury markers for Diagnosis (VALID; n = 337) cohorts. ARDS was defined by Berlin criteria. We used logistic regression to compare in-hospital mortality in patients with and without ARDS, controlling for baseline severity of illness. We also estimated attributable mortality, adjusted for illness severity by stratification.ResultsARDS occurred in 195 EARLI patients (41%) and 99 VALID patients (29%). ARDS was independently associated with risk of hospital death in multivariate analysis, even after controlling for severity of illness, as measured by APACHE II (odds ratio [OR] 1.65 (95% confidence interval [CI] 1.02, 2.67), p = 0.04 in EARLI; OR 2.12 (CI 1.16, 3.92), p = 0.02 in VALID). Patients with severe ARDS (P/F

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3cs7q71hTest