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Table 3 Studies measuring cytokines in patients with or at risk for ARDS

From: Serum biomarkers in Acute Respiratory Distress Syndrome an ailing prognosticator

Investigator Patients Controls Biomarker / Summary ROC curve analysis Cut-off values Specificity – Sensitivity PPV – NPV Limitations
Lesur et al. 20 19 ARDSa
14 at risk
20 controls
Association of early low serum
IL-2 levels with the patients' survival
No Not estimated Small number of patients
No ROC curve analysis / cut-off levels
No serial measurement
Discrepancies in serum and BALF IL-2 levels
Limited number of studied molecules
Parsons et al. 23 77 at risk Association of serum IL-1ra, IL-10 levels with the disease outcome No Not estimated No ROC curve analysis / cut-off levels
Poor predictive value for ARDS development
Limited number of studied molecules
Takala et al. 24 52 at risk
9 ARDSa
45 controls
IL-8, IL-6, sIL-2R, E-selectin, procalcitonin
Persistent elevation of inflammatory markers in patients with ALI precedes its clinical diagnosis
No Not estimated Small number of non-survivors
No ROC curve analysis / cut-off levels
Poor predictive value for ARDS development
Bouros et al. 25 32 ARDSa
27 at risk
IL-4, IL-6, IL-6r, IL-8, IL-10
High prognostic value of all the inflammatory markers in assessing the outcome in patients with or at risk for ARDS
Yes
IL-4: 84 pg/ml
IL-6: 160 pg/ml
IL-6r: 18 pg/ml
IL-8: 2340 pg/ml
IL-10: 98 pg/ml
IL-4: 78-100-81-100%
IL-6: 59-96-69-94%
IL-6r: 78-76-76-78%
IL-8: 93-96-92-96%
IL-10: 96-92-96-93%
Small sample size
No serial measurement
Grouping and definition criteria
Schutte et al. 26 30 ARDSa
44 at risk
17 controls
IL-6, IL-8, TNFa
Serum levels of IL-6 and IL-8 in
ARDS and/or severe pneumonia, differentiate these entities from cardiogenic pulmonary oedema
No Not estimated Small number of patients
Weak correlations with clinical variables
No definitive predictive value for outcome
Overlap of cytokine levels between survivors and non-survivors
No ROC curve analysis / cut-off levels
Bauer et al. 27 46 ARDSa
20 at risk
10 controls
IL-6, IL-1b, TNFa serum levels associate better with the degree of lung injury rather than clarify its specific aetiology No Not estimated Corticosteroid treatment
Inconclusive prognostic value
No serial measurement
Limited number of studied molecules
  1. Abbreviations: ARDS: Acute Respiratory Distress Syndrome, BALF: Bronchoalveolar lavage Fluid, IL-1ra: Interleukin-receptor antagonist, NPV: Negative Predictive Value, PPV: Positive Predictive Value, ROC: Receiver Operating Characteristic, sIL-2R: soluble interleukin-2 receptor, TNFa: Tumor Necrosis Factor-alpha
  2. a: Use the American European Consensus Conference definitions