Long noncoding plasmacytoma variant translocation 1 facilitates the surveillance of acute respiratory distress syndrome and mortality prediction in sepsis

2021 ◽  
Vol 15 (6) ◽  
pp. 401-412
Author(s):  
Yijue Liu ◽  
Huan Peng ◽  
Feng Gui
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Disease Severity ◽  
Noncoding Rna ◽  
Distress Syndrome ◽  
Mortality Prediction ◽  
Prediction Of Mortality ◽  
Failure Assessment ◽  
Variant Translocation

Aim: We aimed to investigate the association of long noncoding RNA plasmacytoma variant translocation 1 (lncRNA PVT1) expression with acute respiratory distress syndrome (ARDS) risk and its prognostic value for 28-day mortality in sepsis patients. Materials & methods: LncRNA PVT1 expression from 109 sepsis patients and 100 health controls was detected. General sepsis severity was assessed using acute physiology and chronic health evaluation II score and sequential organ failure assessment score. Results: LncRNA PVT1 had an acceptable predictive value for higher ARDS risk, then was identified as an independent risk factor for sepsis ARDS; LncRNA PVT1 expression positively correlated with general disease severity in sepsis patients; LncRNA PVT1 was overexpressed in 28-day deaths compared with 28-day survivors in sepsis patients. Conclusion: LncRNA PVT1 may facilitate the surveillance of ARDS, general disease severity and the prediction of mortality in sepsis patients.

scholarly journals The Value of Oxygenation Saturation Index in Predicting the Outcomes of Patients with Acute Respiratory Distress Syndrome

2018 ◽  
Vol 7 (8) ◽  
pp. 205 ◽  
Author(s):  
Wan-Ling Chen ◽  
Wei-Ting Lin ◽  
Shu-Chen Kung ◽  
Chih-Cheng Lai ◽  
Chien-Ming Chao
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Saturation Index ◽  
Predictive Performance ◽  
Mortality Prediction ◽  
Apache Ii Score ◽  
Operating Characteristics ◽  
Adult Intensive Care Unit

This study aims to investigate the association between oxygenation saturation index (OSI) and the outcome of acute respiratory distress syndrome (ARDS) patients, and assess the predictive performance of OSI for ARDS patients’ mortality. This study was conducted at one regional hospital with 66 adult intensive care unit (ICU) beds. All patients with ARDS were identified between November 1 2016 and May 31 2018, and their clinical information was retrospectively collected. The lowest PaO2/FiO2 ratio and SpO2/FiO2 ratio and highest mean airway pressure (MAP) were recorded on the first day of ARDS; and oxygen index (OI) and OSI were calculated as (FiO2 × MAP × 100)/PaO2, and (FiO2 × MAP × 100) /SpO2 accordingly. During the study period, a total of 101 patients with ARDS were enrolled, and their mean age was 69.2 years. The overall in-ICU and in-hospital mortality rate was 57.4% and 61.4%, respectively. The patients with in-ICU mortality had higher APACHE II score than the survivors (31.6 ± 9.8 vs. 23.0 ± 9.1, p < 0.001). In addition, mortalities had lower SpO2, and SpO2/FiO2 ratios than the survivors (both p < 0.05). In contrast, survivors had lower OI, and OSI than the mortalities (both p = 0.008). Both OSI (area under curve (AUC) = 0.656, p = 0.008) and OI (AUC = 0.654, p = 0.008) had good predictive performance of mortality among ARDS patients using receiver-operating characteristics (ROC) curves analysis. In addition, the AUC of SpO2/FiO2 (AUC = 0.616, p = 0.046) had better performance for mortality prediction than PaO2/FiO2 (AUC = 0.603, p = 0.08). The patients with OSI greater than 12 had a higher risk of mortality than OSI < 12 (adjusted OR, 5.22, 95% CI, 1.31–20.76, p = 0.019). In contrast, OI, PaO2/FiO2, and SpO2/FiO2 were not found to be significantly associated with increased mortality. OSI is significantly associated with the increased mortality of ARDS patients and can also be a good outcome predictor.

Etiology-associated heterogeneity in acute respiratory distress syndrome

2020 ◽  
Author(s):  
Sheng-Yuan Ruan ◽  
Chun-Ta Huang ◽  
Ying-Chun Chien ◽  
Chun-Kai Huang ◽  
Jung-Yien Chien ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Bacterial Pneumonia ◽  
Distress Syndrome ◽  
Hemodynamic Instability ◽  
Mechanically Ventilated ◽  
Significant Difference ◽  
Failure Assessment ◽  
Chi Squared

Abstract Background: Heterogeneity in acute respiratory distress syndrome (ARDS) has led to many statistically negative clinical trials. Etiology is considered an important source of pathogenesis heterogeneity in ARDS but previous studies have usually adopted a dichotomous classification, such as pulmonary versus extrapulmonary ARDS, to evaluate it. Etiology-associated heterogeneity in ARDS remains poorly described.Methods: In this retrospective cohort study, we described etiology-associated heterogeneity in gas exchange abnormality (PaO2/FiO2 [P/F] and ventilatory ratios), hemodynamic instability, non-pulmonary organ dysfunction as measured by the Sequential Organ Failure Assessment (SOFA) score, biomarkers of inflammation and coagulation, and 30-day mortality. Linear regression was used to model the trajectory of P/F ratios over time. Wilcoxon rank-sum tests, Kruskal-Wallis rank tests and Chi-squared tests were used to compare between-etiology differences. Results: From 1725 mechanically ventilated patients in the ICU, we identified 258 (15%) with ARDS. Pneumonia (48.4%) and non-pulmonary sepsis (11.6%) were the two leading causes of ARDS. Compared with pneumonia associated ARDS, extra-pulmonary sepsis associated ARDS had a greater P/F ratio recovery rate (difference = 13 mmHg/day, p = 0.01), more shock (48% versus 73%, p = 0.01), higher non-pulmonary SOFA scores (6 versus 9 points, p < 0.001), higher d-dimer levels (4.2 versus 9.7 mg/L, p = 0.02) and higher mortality (43% versus 67%, p = 0.02). In pneumonia associated ARDS, there was significant difference in proportion of shock (p = 0.005) between bacterial and non-bacterial pneumonia.Conclusion: This study showed that there was remarkable etiology-associated heterogeneity in ARDS. Heterogeneity was also observed within pneumonia associated ARDS when bacterial pneumonia was compared with other non-bacterial pneumonia. Future studies on ARDS should consider reporting etiology-specific data and exploring possible effect modification associated with etiology.

scholarly journals Silencing of long noncoding RNA H19 alleviates pulmonary injury, inflammation and fibrosis in acute respiratory distress syndrome rats through regulating MicroRNA-423-5p

2020 ◽  
Author(s):  
Xianyu Mu ◽  
Hongrong Wang ◽  
Haiyong Li
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Long Noncoding Rna ◽  
Noncoding Rna ◽  
Distress Syndrome ◽  
Luciferase Reporter ◽  
Pulmonary Injury ◽  
Tnf Α ◽  
Histology Score

Abstract Background: This study aimed to explore the function of long noncoding RNA H19 (H19) on pulmonary injury, inflammation and fibrosis in lipoproteins (LPS)-induced acute respiratory distress syndrome (ARDS) rats. Methods: The LPS-induced ARDS rat model was established by intratracheal instillation with 2 mg/kg LPS. QRT-PCR was performed to detect the expression of H19, miR-423-5p, tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6,, monocyte chemoattractant protein (MCP)-1 and vascular endothelial growth factor (VEGF). Histology score was detected by hematoxylin-eosin (HE) staining. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of proinflammatory cytokines and the concentration of VEGF in bronchoalveolar lavage fluid (BALF). The protein expression of fiber factors was measured by western blot. The degree of fibrosis was observed by masson-trichrome staining. Dual-luciferase reporter assay was used to determine the binding site between miR-423-5p and H19.Results: The expression of H19 was significantly increased, while miR-423-5p was decreased in LPS-induced ARDS rats. Silencing of H19 decreased the mRNA expression of TNF-α, IL-1β, IL-6, MCP-1 and VEGF in LPS-induced ARDS rats, and decreased the levels of TNF-α, IL-1β, IL-6and the concentration of VEGF in BALF, histology score of LPS-induced ARDS rats. H19 inhibition also decreased the fibrosis score and the proteins expression of fiber factors of LPS-induced ARDS rats. Furthermore, miR-423-5p eliminated the effect of H19 on LPS-induced MH-S cells.Conclusions: Silencing of H19 ameliorated the pulmonary injury, inflammation and fibrosis of LPS-induced ARDS through regulating miR-423-5p, which may be a promising therapeutic strategy to treat ARDS.

scholarly journals Lung ultrasound predicts acute respiratory distress syndrome in patients with paraquat intoxication

2017 ◽  
Vol 24 (6) ◽  
pp. 275-281 ◽  
Author(s):  
Xiao Lu ◽  
DingQian Wu ◽  
YuZhi Gao ◽  
Mao Zhang
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Organ Failure ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Lung Aeration ◽  
Failure Assessment ◽  
Ultrasound Score ◽  
The Impact

Objective: We assessed the evolution of lung aeration by “Lung Ultrasound Score” to predict the acute respiratory distress syndrome in patients with paraquat intoxication. Methods: Patients with paraquat intoxication treated in the intensive care unit were reviewed. Patients who had been assessed by transthoracic lung ultrasound at 3 time points as day 1, day 3, and day 7 after the treatment were analyzed. Lung aeration was represented by the lung ultrasound score. The relationship of the score with the development of acute respiratory distress syndrome was evaluated. Results: There were 50 patients included. On day 7, 18 patients developed the acute respiratory distress syndrome. The acute respiratory distress syndrome patients demonstrated a higher mortality rate than that for the non-acute respiratory distress syndrome patients (88.9% vs 31.5%, p < 0.001). In addition, the acute respiratory distress syndrome patients not only had a higher creatinine level (p < 0.001), and Sepsis-related Organ Failure Assessment 48-h scores (p < 0.001), and a longer time to gastric lavage but also suffered from a lower PaO2/FiO2 (p < 0.001) and a higher lung ultrasound score (p < 0.001) compared to those in the non-acute respiratory distress syndrome patients. The decrease in PaO2/FiO2 between day 3 and day 7 correlated with the increase in lung ultrasound score between day 3 and day 7. There was also a significant correlation between the Sepsis-related Organ Failure Assessment score and lung ultrasound score in acute respiratory distress syndrome patient on day 7. Conclusion: The transthoracic lung ultrasound may be a useful tool for lung aeration assessment on patients with paraquat intoxication receiving treatment. Further studies are needed to evaluate the impact of this screening strategy on predicting acute respiratory distress syndrome.

Mechanical power in acute respiratory distress syndrome : A possible modeling of mortality prediction

2017 ◽  
Vol 42 ◽  
pp. 383
Author(s):  
Leandro Oliveira Dellacqua ◽  
Augusto Cezar Marins Gomes ◽  
Marina Costa Cavallaro ◽  
Marcelo Park
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Mortality Prediction ◽  
Mechanical Power
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