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Table 4 Studies measuring markers of endothelium activation 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
Donnelly et al. 39 82 at risk
14 ARDSa
62 controls
E-selectin levels were not correlated with ARDS development and patients' mortality. L-selectin levels exhibited a significant prognostic value No Not estimated Heterogeneity of studied population (trauma-sepsis)
No ROC curve analysis / cut-off levels No serial measurement
Boldt et al. 40 50 at risk Constantly lower E-selectin, ICAM-1 and VCAM-1 levels in survivors experiencing polytrauma than in nonsurvivors No Not estimated Small sample size
Causal diversity of patient group
No definitive association with patients' mortality
No ROC curve analysis / cut-off levels
Cowley et al. 41 40 SIRS
85 controls
Superiority of E-selectin plasma levels in predicting organ dysfunction and death patients with SIRS comparing to ICAM-1 No Not estimated Small number of patients
Causal diversity of patients studied
No ROC curve analysis / cut-off levels
Sessler et al. 43 25 at risk
12 controls
Association of elevated ICAM-1
Sequential plasma levels with the severity of shock
Yes
ICAM-1: 715 ng/ml (predicting survival)
Not reported Small sample size
Heterogeneity of studied population
Inconclusive association with disease Severity
Kayal et al. 44 32 at risk
9 controls
Cut off values of E-selectin, ICAM-1 and VWF serum levels predicted survival outcome Yes
E-selectin: 128 ng/ml
ICAM-1: 715 ng/ml
VWF: 717%
E-selectin: 73-80-67-85%
ICAM-1: 80-90-75-92%
VWF: 87-8080-87%
Small number of patients
Most of the patients developed secondary ALI
Agouridakis et al. 45 23 ARDSa
42 at risk
TNFa, IL-1, ICAM-1, VCAM-1
ICAM-1 and VCAM-1 showed a high NPV for ARDS development
Correlation with the disease outcome
None of the studied markers was an independent factor for ARDS development
Yes
TNFa: 325 pg/ml
IL-1: 225 pg/ml
ICAM-1: 300 pg/ml
VCAM-1: 260 pg/ml
For ARDS development
TNFa: 62-75-38-89%
IL-1: 58-88-39-94%
ICAM-1: 69-75-42-90%
VCAM-1: 73-88-50-95%
Small sample size
No serial measurement
None of the studied markers was an independent factor for ARDS development
  1. Abbreviations: ALI: Acute Lung Injury, ARDS: Acute Respiratory Distress Syndrome, ICAM-1: Intercellular Cell Adhesion Molecule-1, IL: Interleukin, ROC: Receiver Operating Characteristic, SIRS: Systematic Inflammatory Response Syndrome, TNFa: Tumor Necrosis Factor-alpha, VCAM-1: Vascular Cell Adhesion Molecule-1, VWF: von Willebrand factor antigen, a: Use the American European Consensus Conference definitions