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Table 6 Studies measuring markers of neutrophil activation and ferritin 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
Pugin et al. 60 31 at risk
23 ARDSa
IL-8, MMP-2, MMP-9
Plasma levels of inflammatory activity are not useful markers in differentiating permeability from hydrostatic pulmonary edema
No Not estimated Measurement of circulating proinflammatory cytokines without the appreciation of their inhibitors or receptor antagonists is misleading mainly due to a possible neutralization
Small number of patients
No ROC curve analysis / cut-off values
Amat et al. 64 21 ARDSa
14 at risk
Strong association of LTB4 and IL-8 serum levels with the patients' survival. Yes
LTB4: 14 pmol/ml
IL-8: 150 pmol/ml
LTB4 + IL-8: 88-70-85-75% (markers of mortality rate)
LTB4 : 85-72-20-98% (marker of ARDS development)
Small sample size
Lack of adjustment with the disease severity
Inability of LTB4 plasma levels to be an independent predictive marker
Connelly et al. 66 75 at risk
8 ARDSa
Serum ferritin is a sensitive and specific predictor of ARDS development Yes
Ferritin (male):270 ng/ml
Ferritin (female): 680 ng/ml
71-83-86-67%
90-60-82-75%
Limited number of ARDS patients
Heterogeneity of studied population
Sharkey et al. 67 42 at risk
16 ARDSa
Correlation of ferritin plasma levels with the development of ARDS, multiple organ failure and severity of lung injury Yes
Ferritin (male):270 ng/ml
Ferritin (female): 680 ng/ml
64-73-75-62%
92-60-95-75%
Inadequate sample volume
Not specific cut-off values
Elevated serum levels may reflect a systemic response to a risk factor
  1. Abbreviations: ARDS: Acute Respiratory Distress Syndrome, IL: Interleukin, LTB4: Leukotriene B4, MMP-Metalloproteinase, NPV: Negative Predictive Value, PPV: Positive Predictive Value, ROC: Receiver Operating Characteristic, a: Use the American European Consensus Conference definitions