Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan ; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi 813, Taiwan.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan ; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi 813, Taiwan ; Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Dis Markers. 2014;2014:804654. doi: 10.1155/2014/804654. Epub 2014 Mar 3.
This study aimed to identify the independent biomarkers and clinical factors that could predict ICU mortality and 6-month outcomes in relatively healthy patients with severe pneumonia and acute respiratory distress syndrome (ARDS).
We prospectively enrolled patients with severe pneumonia-related ARDS that required mechanical ventilation. Patients were excluded if they were unable to take care of themselves. Several biomarkers and clinical factors were evaluated prospectively on day 1 and day 3 after ICU admission. All biomarkers and clinical factors were collected for analysis.
56 patients were enrolled in this study. We determined that the initial appropriate antibiotics use was an independent clinical factor and day 1 high-mobility group protein B1 (HMGB1) concentration was an independent biomarker for ICU mortality. Interestingly, we also found that a low day 1 albumin level was an independent biomarker for predicting patient life dependence 6 months after a pneumonia event.
Patients with severe pneumonia and ARDS requiring mechanical ventilation experience high rates of ICU mortality or disability, even if they were quite healthy before. Initial appropriate antibiotics use and day 1 level of HMGB1 were independent factors for predicting ICU mortality. Day 1 albumin level was predictive of 6-month patient life dependence.
本研究旨在确定能够预测相对健康的严重肺炎合并急性呼吸窘迫综合征（ARDS）患者 ICU 死亡率和 6 个月结局的独立生物标志物和临床因素。
我们前瞻性纳入需要机械通气的严重肺炎相关 ARDS 患者。排除无法自理的患者。在 ICU 入院后第 1 天和第 3 天，前瞻性评估了几种生物标志物和临床因素。所有生物标志物和临床因素均进行了分析。
本研究共纳入 56 例患者。我们确定初始适当使用抗生素是一个独立的临床因素，第 1 天高迁移率族蛋白 B1（HMGB1）浓度是预测 ICU 死亡率的独立生物标志物。有趣的是，我们还发现，第 1 天白蛋白水平较低是预测肺炎事件 6 个月后患者生活依赖的独立生物标志物。
即使在发病前相当健康，需要机械通气的严重肺炎合并 ARDS 患者 ICU 死亡率或残疾率仍较高。初始适当使用抗生素和第 1 天 HMGB1 水平是预测 ICU 死亡率的独立因素。第 1 天白蛋白水平可预测 6 个月患者的生活依赖。
