Surfactant Protein D Is Associated With Severe Pediatric ARDS, Prolonged Ventilation, and Death in Children With Acute Respiratory Failure.

Adolescent Biomarkers / blood Child Child, Preschool Female Humans Infant Infant, Newborn Length of Stay / statistics & numerical data Male Prospective Studies Pulmonary Surfactant-Associated Protein D / blood Respiration, Artificial / statistics & numerical data Respiratory Distress Syndrome / blood Respiratory Distress Syndrome, Newborn / blood Severity of Illness Index
ARDS biomarker critical illness length of mechanical ventilation mortality outcome pediatric ARDS pediatrics surfactant

Journal

Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335

Informations de publication

Date de publication:
09 2020
Historique:
received: 13 10 2019
revised: 03 02 2020
accepted: 09 03 2020
pubmed: 11 4 2020
medline: 27 5 2021
entrez: 11 4 2020
Statut: ppublish

Résumé

Elevated surfactant protein D (SP-D) is a relatively specific indicator of lung injury and is associated with both acute and chronic lung disease in adults and respiratory distress syndrome in premature infants. The relationship between plasma SP-D and lung injury in children with acute respiratory failure is unclear. Is plasma SP-D associated with lung injury or outcome in children with acute respiratory failure? This was a prospective cohort study in children 2 weeks to 17 years of age with acute respiratory failure who participated in the BALI multi-center study. Analyses were done using SP-D levels in plasma from the first sample taken on either the day of intubation or one of the following 2 days. SP-D level was measured by enzyme-linked immunosorbent assay. Plasma samples from 350 patients were used in the analysis; 233 had pediatric ARDS (PARDS). SP-D levels varied across primary diagnoses (P < .001). Elevated SP-D levels were associated with severe PARDS after adjusting for age, pediatric risk of mortality III (PRISM-III), and primary diagnosis (OR = 1.02; CI = 1.01-1.04; P = .011). Multivariable analyses also indicated that elevated SP-D levels were associated with death (OR = 1.02; CI = 1.01-1.04; P = .004), duration of mechanical ventilation (P = .012), PICU length of stay (P = .019), and highest oxygenation index (P = .040). SP-D levels also correlated with age (r Elevated plasma SP-D levels are associated with severe PARDS and poor outcomes in children with acute respiratory failure. Future studies will determine whether SP-D can be used to predict the degree of lung injury or response to treatment and whether SP-D is useful in identifying PARDS endotypes.

Sections du résumé

BACKGROUND
Elevated surfactant protein D (SP-D) is a relatively specific indicator of lung injury and is associated with both acute and chronic lung disease in adults and respiratory distress syndrome in premature infants. The relationship between plasma SP-D and lung injury in children with acute respiratory failure is unclear.
RESEARCH QUESTION
Is plasma SP-D associated with lung injury or outcome in children with acute respiratory failure?
STUDY DESIGN AND METHODS
This was a prospective cohort study in children 2 weeks to 17 years of age with acute respiratory failure who participated in the BALI multi-center study. Analyses were done using SP-D levels in plasma from the first sample taken on either the day of intubation or one of the following 2 days. SP-D level was measured by enzyme-linked immunosorbent assay.
RESULTS
Plasma samples from 350 patients were used in the analysis; 233 had pediatric ARDS (PARDS). SP-D levels varied across primary diagnoses (P < .001). Elevated SP-D levels were associated with severe PARDS after adjusting for age, pediatric risk of mortality III (PRISM-III), and primary diagnosis (OR = 1.02; CI = 1.01-1.04; P = .011). Multivariable analyses also indicated that elevated SP-D levels were associated with death (OR = 1.02; CI = 1.01-1.04; P = .004), duration of mechanical ventilation (P = .012), PICU length of stay (P = .019), and highest oxygenation index (P = .040). SP-D levels also correlated with age (r
INTERPRETATION
Elevated plasma SP-D levels are associated with severe PARDS and poor outcomes in children with acute respiratory failure. Future studies will determine whether SP-D can be used to predict the degree of lung injury or response to treatment and whether SP-D is useful in identifying PARDS endotypes.

Identifiants

DOI: 10.1016/j.chest.2020.03.041 PMID: 32275979 PMC: PMC7478231
pubmed: 32275979
pii: S0012-3692(20)30573-0
doi: 10.1016/j.chest.2020.03.041
pmc: PMC7478231
pii:
doi:

Substances chimiques

Biomarkers 0
Pulmonary Surfactant-Associated Protein D 0

Types de publication

Journal Article Multicenter Study Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1027-1035

Subventions

Organisme : NHLBI NIH HHS
ID : R01 HL095410
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL086622
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL086649
Pays : United States

Investigateurs

Scot T Bateman (ST)
M D Berg (MD)
Santiago Borasino (S)
G Kris Bysani (GK)
Allison S Cowl (AS)
Cindy Darnell Bowens (CD)
E Vincent S Faustino (EVS)
Lori D Fineman (LD)
A J Godshall (AJ)
Ellie Hirshberg (E)
Aileen L Kirby (AL)
Gwenn E McLaughlin (GE)
Shivanand Medar (S)
Phineas P Oren (PP)
James B Schneider (JB)
Adam J Schwarz (AJ)
Thomas P Shanley (TP)
Lauren R Sorce (LR)
Edward J Truemper (EJ)
Michele A Vander Heyden (MA)
Kim Wittmayer (K)
Athena Zuppa (A)
David Wypij (D)

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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Auteurs

Mary K Dahmer (MK)

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI.

Heidi Flori (H)

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI.

Anil Sapru (A)

Department of Pediatrics, University of California, Los Angeles, CA.

Joseph Kohne (J)

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI.

Heidi M Weeks (HM)

Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI.

Martha A Q Curley (MAQ)

Department of Family and Community Health (School of Nursing), Division of Anesthesia and Critical Care Medicine (Perelman School of Medicine) University of Pennsylvania, and the Research Institute, Children's Hospital of Philadelphia, Philadelphia, PA.

Michael A Matthay (MA)

Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA.

Michael W Quasney (MW)

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI. Electronic address: mquasney@med.umich.edu.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Surfactant Protein D Is Associated With Severe...
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questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Protéines associées au surfactant pulmonaire › Protéine D associée au surfactant pulmonaire › Surfactant Protein D Is Associated With Severe...
questionsmedicales.fr › Thérapeutique › Thérapie respiratoire › Ventilation artificielle › Surfactant Protein D Is Associated With Severe...
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