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Table 5 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
Rubin et al. 47 45 at risk Elevated plasma VWF is an early predictor of ALI in nonpulmonary sepsis syndrome Yes
VWF: 450%
77-87-80% Small sample size 25% of patients had already lung injury at the time sepsis was diagnosed
Exclusion of patients who developed
ALI from a primary pulmonary source VWF levels measured by an old assay
Ware et al. 48 51 ALI/ ARDSa
4 controls
VWF is an independent predictor of hospital mortality in patients with ALI No
91-44-83-62% Inadequate sample volume
Heterogeneity of studied population
No ROC curve analysis
Ware et al. 49 559
Significant correlation of elevated VWF plasma levels with mortality, duration of unassisted ventilation and organ failures. No differences of VWF levels between septic and non septic patients No Not estimated Not definitive association with patients' mortality
Lack of knowledge regarding the cellular source and the mechanisms of elevated VWF serum levels
No ROC curve analysis / cut-off values
Moalli et al. 50 35 at risk
9 controls
VWF levels were higher in ARDS compared with at risk
VWF levels are not helpful in predicting ARDS development
No Not reported Limited number of patients
No ROC curve analysis / cut-off values
Moss et al. 51 96 at risk VWF is not predictive of development of ARDS Yes
Causal diversity of patients studied
No definitive relation with disease severity
Sabharwal et al. 52 22 ARDS
21 at risk
No significant association of VWF blood levels with patients' mortality No Not estimated Small sample size
Retrospective study
No ROC curve analysis / cut-off values
Bajaj et al. 53 18 ARDS
15 at risk
27 controls
Serum VWF levels were non-useful markers for predicting ARDS in at risk patients Yes
VWF: 300%
71-62-34% Limited number of patients
No serial measurement
Coexisting multisystem organ failure
Heterogeneity of studied population
Moss et al. 54 55 at risk
11 controls
ICAM-1, E-selectin, VWF
Degree of endothelial activation varied in patients at risk for ARDS from different etiologic factors
No Not estimated Small sample size
Heterogeneity of studied population
  1. Abbreviations: ALI: Acute Lung Injury, ARDS: Acute Respiratory Distress Syndrome, ICAM-1: Intercellular Cell Adhesion Molecule-1, NPV: Negative Predictive Value, PPV: Positive Predictive Value, ROC: Receiver Operating Characteristic, VCAM-1: Vascular Cell Adhesion Molecule-1, VWF: von Willebrand factor antigen
  2. a: Use the American European Consensus Conference definitions