Early elevation of plasma soluble intercellular adhesion molecule-1 in pediatric acute lung injury identifies patients at increased risk of death and prolonged mechanical ventilation.
Early elevation of plasma soluble intercellular adhesion molecule-1 in pediatric acute lung injury identifies patients at increased risk of death and prolonged mechanical ventilation.
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DOI：
10.1097/01.pcc.0000074583.27727.8e
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发表时间：
2003-07-01
期刊：
影响因子：
--
通讯作者：
Matthay, Michael A
中科院分区：
文献类型：
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作者：
Flori, Heidi R;Ware, Lorraine B;Matthay, Michael A
目的：确定急性肺损伤患儿血浆中可溶性细胞间粘附分子（sICAM）-1（肺泡上皮和肺内皮损伤及肺泡巨噬细胞活化的生物标志物）是否升高，并检查血浆sICAM-1水平升高是否与两个临床相关结局（死亡率和机械通气持续时间）相关。在城市儿童医院和第三大学医学中心的儿科重症监护室。患者：83例急性肺损伤的儿科患者和5例插管对照。干预：在儿科患者急性肺损伤的第1天和第2天以及对照患者机械通气的第1天测量血浆sICAM-1水平。测量和主要结果：急性肺损伤患者的血浆sICAM-1水平显著高于对照组（966 +/- 830 vs. 251 +/- 168 ng/mL，p 1000 ng/mL对识别急性肺损伤的非幸存者具有高特异性。急性肺损伤患儿血浆中sICAM-1的早期升高与死亡风险增加或机械通气时间延长相关。
OBJECTIVE: To determine whether soluble intercellular adhesion molecule (sICAM)-1, a biological marker of alveolar epithelial and lung endothelial injury and alveolar macrophage activation, is elevated in the plasma of pediatric patients with acute lung injury and to examine whether elevated plasma sICAM-1 levels correlate with two clinically relevant outcomes, mortality and the duration of mechanical ventilation.DESIGN: Prospective cohort study.SETTING: Pediatric intensive care units at an urban children's hospital and a tertiary university medical center.PATIENTS: Eighty-three pediatric patients with acute lung injury and five intubated controls.INTERVENTIONS: Plasma sICAM-1 levels were measured on days 1 and 2 of acute lung injury in pediatric patients and on day 1 of mechanical ventilation in control patients.MEASUREMENTS AND MAIN RESULTS: Plasma sICAM-1 levels were significantly higher in patients with acute lung injury compared with controls (966 +/- 830 vs. 251 +/- 168 ng/mL, p 1000 ng/mL had a high specificity for identifying nonsurvivors of acute lung injury.CONCLUSIONS: Early elevation of sICAM-1 in the plasma of pediatric patients with acute lung injury is associated with increased risk of death or prolonged duration of mechanical ventilation.