scholarly journals Lung Injury Prediction Score Is Useful in Predicting Acute Respiratory Distress Syndrome and Mortality in Surgical Critical Care Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Zachary M. Bauman ◽  
Marika Y. Gassner ◽  
Megan A. Coughlin ◽  
Meredith Mahan ◽  
Jill Watras
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Prediction Score ◽  
Surgical Patients ◽  
Surgical Intensive Care Unit ◽  
Injury Prediction ◽  
Ventilated Patients

Background. Lung injury prediction score (LIPS) is valuable for early recognition of ventilated patients at high risk for developing acute respiratory distress syndrome (ARDS). This study analyzes the value of LIPS in predicting ARDS and mortality among ventilated surgical patients.Methods. IRB approved, prospective observational study including all ventilated patients admitted to the surgical intensive care unit at a single tertiary center over 6 months. ARDS was defined using the Berlin criteria. LIPS were calculated for all patients and analyzed. Logistic regression models evaluated the ability of LIPS to predict development of ARDS and mortality. A receiver operator characteristic (ROC) curve demonstrated the optimal LIPS value to statistically predict development of ARDS.Results. 268 ventilated patients were observed; 141 developed ARDS and 127 did not. The average LIPS for patients who developed ARDS was8.8±2.8versus5.4±2.8for those who did not (p<0.001). An ROC area under the curve of 0.79 demonstrates LIPS is statistically powerful for predicting ARDS development. Furthermore, for every 1-unit increase in LIPS, the odds of developing ARDS increase by 1.50 (p<0.001) and odds of ICU mortality increase by 1.22 (p<0.001).Conclusion. LIPS is reliable for predicting development of ARDS and predicting mortality in critically ill surgical patients.

scholarly journals Lung Injury Prediction Score in Hospitalized Patients at Risk of Acute Respiratory Distress Syndrome

2016 ◽  
Vol 44 (12) ◽  
pp. 2182-2191 ◽  
Author(s):  
Graciela J. Soto ◽  
Daryl J. Kor ◽  
Pauline K. Park ◽  
Peter C. Hou ◽  
David A. Kaufman ◽  
...  
Keyword(s):  
At Risk ◽  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hospitalized Patients ◽  
Prediction Score ◽  
Injury Prediction ◽  
Patients At Risk

scholarly journals The neutrophil chemoattractant peptide proline-glycine-proline is associated with acute respiratory distress syndrome

2018 ◽  
Vol 315 (5) ◽  
pp. L653-L661 ◽  
Author(s):  
Nirmal S. Sharma ◽  
Charitharth Vivek Lal ◽  
Jin-dong Li ◽  
Xiang-yang Lou ◽  
Liliana Viera ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Neutrophil Infiltration ◽  
Polymorphonuclear Neutrophil ◽  
Apache Score ◽  
Ventilated Patients

Acute respiratory distress syndrome (ARDS) is characterized by unrelenting polymorphonuclear neutrophil (PMN) inflammation and vascular permeability. The matrikine proline-glycine-proline (PGP) and acetylated PGP (Ac-PGP) have been shown to induce PMN inflammation and endothelial permeability in vitro and in vivo. In this study, we investigated the presence and role of airway PGP peptides in acute lung injury (ALI)/ARDS. Pseudomonas aeruginosa-derived lipopolysaccharide (LPS) was instilled intratracheally in mice to induce ALI, and increased Ac-PGP with neutrophil inflammation was noted. The PGP inhibitory peptide, arginine-threonine-arginine (RTR), was administered (it) 30 min before or 6 h after LPS injection. Lung injury was evaluated by detecting neutrophil infiltration and permeability changes in the lung. Pre- and posttreatment with RTR significantly inhibited LPS-induced ALI by attenuating lung neutrophil infiltration, pulmonary permeability, and parenchymal inflammation. To evaluate the role of PGP levels in ARDS, minibronchoalveolar lavage was collected from nine ARDS, four cardiogenic edema, and five nonlung disease ventilated patients. PGP levels were measured and correlated with Acute Physiology and Chronic Health Evaluation (APACHE) score, [Formula: see text] to [Formula: see text] (P/F), and ventilator days. PGP levels in subjects with ARDS were significantly higher than cardiogenic edema and nonlung disease ventilated patients. Preliminary examination in both ARDS and non-ARDS populations demonstrated PGP levels significantly correlated with P/F ratio, APACHE score, and duration on ventilator. These results demonstrate an increased burden of PGP peptides in ARDS and suggest the need for future studies in ARDS cohorts to examine correlation with key clinical parameters.

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