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 |