ArticleCritical care explorations2020
Endothelial Biomarkers Are Associated With Indirect Lung Injury in Sepsis-Associated Pediatric Acute Respiratory Distress Syndrome.
Article in Critical care explorations, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 28 citations in OpenAlex.
- Review
- Unraveling mortality risk in pediatric acute respiratory distress syndrome: key biomarkers and pathophysiological insights.Pediatric research · 2026Review
- Validation of plasma soluble receptor of advanced glycation end-products and angiopoietin-2 in paediatric acute respiratory distress syndrome.BMJ open respiratory research · 2026Observational
- Risk assessment of pARDS in severe pneumonia patients based on lung injury prediction scores and serum biomarkers.Scientific reports · 2025Article
- Potential biomarkers used for risk estimation of pediatric sepsis-associated organ dysfunction and immune dysregulation.Pediatric research · 2025Review
- Development of an acute lung injury model for drug testing.Scientific reports · 2025Article
- Derivation and Validation of a Clinical and Endothelial Biomarker Risk Model to Predict Persistent Pediatric Sepsis-Associated Acute Respiratory Dysfunction.CHEST critical care · 2025Article
- Review
- Advances and Challenges in Pediatric Sepsis Diagnosis: Integrating Early Warning Scores and Biomarkers for Improved Prognosis.Biomolecules · 2025Review
- By activating endothelium histone H4 mediates oleic acid-induced acute respiratory distress syndrome.BMC pulmonary medicine · 2025Article
- Translational medicine for acute lung injury.Journal of translational medicine · 2024Review
- Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2023Review
- Expression Patterns of Airway Fluid Cytokines From Intubated Children With Pediatric Acute Respiratory Distress Syndrome.Critical care explorations · 2022Article
- Article
- Characterization of "ICU-30": A Binary Composite Outcome for Neonates With Critical Congenital Heart Disease.Journal of the American Heart Association · 2022Article
- Biomarker combinations in predicting sepsis in hospitalized children with fever.BMC pediatrics · 2022Article
- Endothelial Dysfunction after Hematopoietic Stem Cell Transplantation: A Review Based on Physiopathology.Journal of clinical medicine · 2022Review
- Biomarkers associated with mortality in pediatric patients with cardiac arrest and acute respiratory distress syndrome.Resuscitation · 2022Article
- Promises and challenges of personalized medicine to guide ARDS therapy.Critical care (London, England) · 2021Review
- Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesAcute respiratory distress syndrome occurring in the setting of direct versus indirect lung injury may reflect different pathobiologies amenable to different treatment strategies. We sought to test whether a panel of plasma biomarkers differed between children with sepsis-associated direct versus indirect acute respiratory distress syndrome. We hypothesized that a biomarker profile indicative of endothelial activation would be associated with indirect acute respiratory distress syndrome.
designObservational cohort.
settingAcademic PICU. SUBJECTS: Patients less than 18 years old with sepsis-associated direct (pneumonia,
interventionsNone. MEASUREMENTS AND MAIN
resultsOf 58 biomarkers examined, 33 differed by acute respiratory distress syndrome subtype. We used classification and regression tree methodology to examine associations between clinical and biochemical markers and acute respiratory distress syndrome subtype. The classification and regression tree model using only clinical variables (age, sex, race, oncologic comorbidity, and Pediatric Risk of Mortality-III score) performed worse than the classification and regression tree model using five clinical variables and 58 biomarkers. The best classification and regression tree model used only four endothelial biomarkers, including elevated angiopoietin-2/angiopoietin-1 ratio, vascular cell-adhesion molecule, and von Willebrand factor, to identify indirect acute respiratory distress syndrome. Test characteristics were 89% (80-97%) sensitivity, 80% (69-92%) specificity, positive predictive value 84% (74-93%), and negative predictive value 86% (76-96%).
conclusionsIndirect lung injury in children with acute respiratory distress syndrome is characterized by a biomarker profile indicative of endothelial activation, excess inflammation, and worse outcomes. A model using four biomarkers has the potential to be useful for more precisely identifying patients with acute respiratory distress syndrome whose pathobiology may respond to endothelial-targeted therapies in future trials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.