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 |