Plasma bioactive adrenomedullin on intensive care unit admission is associated with acute respiratory distress syndrome : an observational study

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Johnsson, PatrikLund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Anaesthesiology and Intensive Care Medicine,Lund University Research Groups,Skåne University Hospital (författare)

Plasma bioactive adrenomedullin on intensive care unit admission is associated with acute respiratory distress syndrome : an observational study

Artikel/kapitelEngelska2023

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2023-03-03
Springer Science and Business Media LLC,2023

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LIBRIS-ID:oai:lup.lub.lu.se:fd857727-40ec-4375-b5f2-fe3b5e77af46
https://lup.lub.lu.se/record/fd857727-40ec-4375-b5f2-fe3b5e77af46URI
https://doi.org/10.1186/s40635-023-00494-7DOI

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Språk:engelska
Sammanfattning på:engelska

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Background: Bioactive adrenomedullin (bio-ADM) is a vasoactive peptide with a key role in reducing vascular hyperpermeability and improving endothelial stability during infection, but it also has vasodilatory properties. Bioactive ADM has not been studied in conjunction with acute respiratory distress syndrome (ARDS), but it has recently been shown to correlate with outcomes after severe COVID-19. Therefore, this study investigated the association between circulating bio-ADM on intensive care unit (ICU) admission and ARDS. The secondary aim was the association between bio-ADM and ARDS mortality. Methods: We analysed bio-ADM levels and assessed the presence of ARDS in adult patients admitted to two general intensive care units in southern Sweden. Medical records were manually screened for the ARDS Berlin criteria. The association between bio-ADM levels and ARDS and mortality in ARDS patients was analysed using logistic regression and receiver-operating characteristics analysis. The primary outcome was an ARDS diagnosis within 72 h of ICU admission, and the secondary outcome was 30-day mortality. Results: Out of 1224 admissions, 11% (n = 132) developed ARDS within 72 h. We found that elevated admission bio-ADM level was associated with ARDS independently of sepsis status and of organ dysfunction as measured by the Sequential organ failure assessment (SOFA) score. Both lower levels (< 38 pg/L) and high (> 90 pg/L) levels of bio-ADM were independently (of the Simplified acute physiology score, SAPS-3) predictive of mortality. Patients with indirect mechanisms of lung injury had higher bio-ADM levels than those with a direct mechanism of injury, and bio-ADM increased with increasing ARDS severity. Conclusions: High levels of bio-ADM on admission are associated with ARDS, and bio-ADM levels significantly differ depending on the injury mechanism. In contrast, both high and low levels of bio-ADM are associated with mortality, possibly due to the dual action of bio-ADM in stabilising the endothelial barrier and causing vasodilation. These findings could lead to improved diagnostic accuracy of ARDS and potentially lead to new therapeutic strategies.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
Adrenomedullin
Adult respiratory distress syndrome
Biomarker
COVID-19
Endothelial function
Sepsis

Biuppslag (personer, institutioner, konferenser, titlar ...)

Fredriksson, AndreaLund University,Skåne University Hospital (författare)
Tung, ChristerLund University,Skåne University Hospital (författare)
Friberg, HansLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital(Swepub:lu)efor-hfr (författare)
Frigyesi, AttilaLund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Intensivvårdsepidemiologi,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Intensive Care Epidemiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)mats-afr (författare)
Anestesiologi och intensivvårdSektion II (creator_code:org_t)

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Ingår i:Intensive Care Medicine Experimental: Springer Science and Business Media LLC11, s. 1-152197-425X

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Av författaren/redakt...: Johnsson, Patrik; Fredriksson, And ...; Tung, Christer; Friberg, Hans; Frigyesi, Attila

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Anestesi och int ...

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Av lärosätet: Lunds universitet

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