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 VWF:450% | 91-44-83-62% | Inadequate sample volume Heterogeneity of studied population No ROC curve analysis |
Ware et al. 49 | 559 ALI/ ARDSa | 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 10 ARDS 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 VWF:273% VWF:399% | 47-70% 52-64% | 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 14 ARDS 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 |