title: Predictive value of plasma biomarkers for mortality and organ failure development in patients with acute respiratory distress syndrome.
abstract: OBJECTIVE
  To evaluate the predictive value of 6 different biomarkers in the development of multiple-organ failure (MOF) and mortality in a contemporary prospective cohort of acute respiratory distress syndrome (ARDS).
  
  
  METHODS
  Patients with ARDS admitted to a tertiary referral center during an 8-month period were included. Plasma sample collection of 6 different biomarkers on days 1, 3, and 5 after ARDS onset was performed (von Willebrand factor, thrombin-antithrombin III complex, plasminogen activator inhibitor 1, interleukin 8, receptor for advanced glycation end-products, and club cell secretory protein). Main outcomes included hospital mortality and development of MOF. Logistic regression models for MOF and mortality prediction were created including biomarkers levels and clinical predictors.
  
  
  RESULTS
  One hundred patients were included in the study. Do-not-resuscitate status and McCabe score were independently associated with increased mortality. None of the 6 biomarkers measured at the time of ARDS diagnosis predicted hospital mortality. After adjustment for important clinical characteristics, elevated day-1 interleukin 8 levels were associated with the development of MOF.
  
  
  CONCLUSIONS
  Addition of biomarkers did not improve mortality prediction in this cohort of ARDS. Association between elevated interleukin 8 levels and progression of organ failures suggests an important role of exaggerated inflammatory response in the development of MOF.
authors.affiliation: Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN. Electronic address: cartinceba.rodrigo@mayo.edu.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Cartin-Ceba
authors.affiliation: Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Rolf D
authors.initials: RD
authors.lastname: Hubmayr
authors.affiliation: Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors.forename: Rui
authors.initials: R
authors.lastname: Qin
authors.affiliation: Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Steve
authors.initials: S
authors.lastname: Peters
authors.affiliation: Laboratory of Experimental Intensive Care and Anesthesiology and Department of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Rogier M
authors.initials: RM
authors.lastname: Determann
authors.affiliation: Laboratory of Experimental Intensive Care and Anesthesiology and Department of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Schultz
authors.affiliation: Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Ognjen
authors.initials: O
authors.lastname: Gajic
mesh_terms: D018806:APACHE; D000368:Aged; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000401:mortality*; D010447:Peptide Hydrolases / Q000097:blood; D064801:Phospholipase A2 Inhibitors / Q000097:blood; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011446:Prospective Studies; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000401:mortality*; D016414:Resuscitation Orders; D014598:Uteroglobin / Q000097:blood; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D015415:Biomarkers; D016209:Interleukin-8; D064801:Phospholipase A2 Inhibitors; D017395:Plasminogen Activator Inhibitor 1; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic; C556389:SCGB1A1 protein, human; C046193:antithrombin III-protease complex; D014841:von Willebrand Factor; D000990:Antithrombin III; D014598:Uteroglobin; D010447:Peptide Hydrolases
keywords: ARDS; Biomarkers; Organ failures; Prognosis