title: Natriuretic peptide proANP (1-98), a biomarker of ALI/ARDS in burns.
abstract: BACKGROUND
  Plasma atrial natriuretic peptide levels (proANP (1-98)), a parameter of myocardial dysfunction, have been reported to be increased in critically ill patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS). The aim of the study was to examine if proANP is a biomarker of ALI/ARDS as assessed by the Sequential Organ Failure Assessment score (SOFA Lung ≥2) in burn patients, and how it compares to the corresponding values for age, total body surface area percent (TBSA%) and inhalation injury for mortality prediction.
  
  
  METHODS
  A group of 22 burn patients with a mean TBSA of 30% (10-75%) and a mean age of 52 years (25-84 years) was investigated during 2010. Organ dysfunction/failure was classified according to the SOFA score. The criteria for ALI/ARDS were based on SOFA Lung ≥2. ProANP (1-98) concentrations (nmoll(-1)) were measured by commercially available enzyme linked immunosorbent assay (ELISA) immunoassays (Biomedica Austria) on post-burn days 2 and 7.
  
  
  RESULTS
  ProANP levels on day 7 post-burn positively correlated with a SOFA score day 7 post-burn, c=0.91. The receiver operating curve (ROC) analysis proved a sensitivity of 75% and a specificity of 75% for ALI/ARDS at cut-off values >3.35 nmoll(-1). The ROC value of proANP for ALI/ARDS (SOFA Lung ≥2) was significantly larger than that of age, TBSA% and inhalation injury: 0.90, 0.71, 0.74, and 0.69 (p<0.001).
  
  
  CONCLUSIONS
  ProANP levels, as a biomarker of ALI/ARDS, in critically burn patients correlated with SOFA scoring. The inhalation injury did not lead to increase in proANP values.
authors.affiliation: Prague Burn Center, Third Faculty of Medicine, Charles University, Prague, Czech Republic. monika.tokarik@fnkv.cz
authors.forename: Monika
authors.initials: M
authors.lastname: Tokarik
authors.forename: Folke
authors.initials: F
authors.lastname: Sjöberg
authors.forename: David
authors.initials: D
authors.lastname: Vajtr
authors.forename: Ludomir
authors.initials: L
authors.lastname: Broz
authors.forename: Martin
authors.initials: M
authors.lastname: Balik
authors.forename: Jana
authors.initials: J
authors.lastname: Vranova
mesh_terms: D055371:Acute Lung Injury / Q000097:blood* / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002056:Burns / Q000097:blood / Q000150:complications*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012044:Regression Analysis; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000209:etiology; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D009320:Atrial Natriuretic Factor