ArticleTrauma surgery & acute care open2017
Derivation and validation of a two-biomarker panel for diagnosis of ARDS in patients with severe traumatic injuries.
Article in Trauma surgery & acute care open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- A systematic review of biomarkers multivariately associated with acute respiratory distress syndrome development and mortality.Critical care (London, England) · 2020Pooled it
- Statins Restore Endothelial Protection against Complement Activity in Obstructive Sleep Apnea: A Randomized Clinical Trial.Annals of the American Thoracic Society · 2023Trial
- Anesthetics to Prevent Lung Injury in Cardiac Surgery: A Randomized Controlled Trial.Journal of cardiothoracic and vascular anesthesia · 2022Trial
- Acute lung injury induced by traumatic hemorrhagic shock: pathogenesis, biomarkers and therapeutic perspectives.World journal of emergency medicine · 2025Article
- Oxidized Cell-Free Hemoglobin Induces Mitochondrial Dysfunction by Activation of the Mitochondrial Permeability Transition Pore in the Pulmonary Microvasculature.Microcirculation (New York, N.Y. : 1994) · 2025Article
- Impact of acute stress disorder on surfactant protein D levels in acute lung injury.Journal of molecular histology · 2024Article
- Children with single ventricle heart disease have a greater increase in sRAGE after cardiopulmonary bypass.Perfusion · 2024Observational
- Developing a predictive nomogram for mortality in patients with extrapulmonary acute respiratory distress syndrome: the prognostic value of serum soluble thrombomodulin, lung ultrasound score, and lactate.Frontiers in pharmacology · 2024Article
- Serum Angiopoietin-2 level increase differs between polytraumatized patients with and without central nervous system injuries.Scientific reports · 2023Article
- Are circulating endothelial cells the next target for transcriptome-level pathway analysis in ARDS?American journal of physiology. Lung cellular and molecular physiology · 2023Article
- Precision Medicine Using Simultaneous Monitoring and Assessment with Imaging and Biomarkers to Manage Mechanical Ventilation in ARDS.Intensive care research · 2023Review
- Circulatory HMGB1 is an early predictive and prognostic biomarker of ARDS and mortality in a swine model of polytrauma.Frontiers in immunology · 2023Article
- Aerosolized vitamin E acetate causes oxidative injury in mice and in alveolar macrophages.American journal of physiology. Lung cellular and molecular physiology · 2022Article
- Management of COVID-19-Associated Acute Respiratory Failure with Alternatives to Invasive Mechanical Ventilation: High-Flow Oxygen, Continuous Positive Airway Pressure, and Noninvasive Ventilation.Diagnostics (Basel, Switzerland) · 2021Review
- Clinical and biological markers for predicting ARDS and outcome in septic patients.Scientific reports · 2021Observational
- Impact of Clinician Recognition of Acute Respiratory Distress Syndrome on Evidenced-Based Interventions in the Medical ICU.Critical care explorations · 2021Article
- Plasma Soluble Suppression of Tumorigenicity-2 Associates with Ventilator Liberation in Acute Hypoxemic Respiratory Failure.American journal of respiratory and critical care medicine · 2021Article
- Systematic review of diagnostic methods for acute respiratory distress syndrome.ERJ open research · 2021Review
- Novel Perspectives Regarding the Pathology, Inflammation, and Biomarkers of Acute Respiratory Distress Syndrome.International journal of molecular sciences · 2020Review
- Endothelial Damage in Acute Respiratory Distress Syndrome.International journal of molecular sciences · 2020Review
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundAcute respiratory distress syndrome (ARDS) is common after severe traumatic injuries but is underdiagnosed and undertreated. We hypothesized that a panel of plasma biomarkers could be used to diagnose ARDS in severe trauma. To test this hypothesis, we derived and validated a biomarker panel in three independent cohorts and compared the diagnostic performance to clinician recognition of ARDS.
methodsEleven plasma biomarkers of inflammation, lung epithelial and endothelial injury were measured in a derivation cohort of 439 severe trauma patients. ARDS status was analyzed by two-investigator consensus, and cases were required to meet Berlin criteria on intensive care unit (ICU) day 1. Controls were subjects without ARDS during the first 4 days of study enrollment. A multivariable logistic regression model was used to generate probabilities for ARDS. A reduced model with the top two performing markers was then tested in two independent validation cohorts. To assess clinical diagnosis of ARDS, medical records in the derivation cohort were systematically searched for documentation of ARDS diagnosis made by a clinical provider.
resultsAmong 11 biomarkers, the combination of the endothelial injury marker angiopoietin-2 (Ang-2) and the lung epithelial injury marker receptor for advanced glycation endproducts (RAGE) provided good discrimination for ARDS in the derivation cohort (area under the curve (AUC)=0.74 (95% CI 0.67 to 0.80). In the validation cohorts, the AUCs for this model were 0.70 (0.61 to 0.77) and 0.78 (0.71 to 0.84). In contrast, provider assessment demonstrated poor diagnostic accuracy for ARDS, with AUC of 0.55 (0.51 to 0.60). DISCUSSION: A two-biomarker panel consisting of Ang-2 and RAGE performed well across multiple patient cohorts and outperformed clinical providers for diagnosing ARDS in severe trauma. Clinical application of this model could improve both diagnosis and treatment of ARDS in patients with severe trauma. LEVEL OF EVIDENCE: Diagnostic study, level II.
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