Boesing Christoph, Graf Peter T, Thiel Manfred, Luecke Thomas, Krebs Joerg
Department of Anaesthesiology and Critical Care Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
J Clin Med. 2021 Aug 19;10(16):3686. doi: 10.3390/jcm10163686.
: Procollagen peptides have been associated with lung fibroproliferation and poor outcomes in patients with acute respiratory distress syndrome (ARDS). Therefore, serum procollagen concentrations might have prognostic value in ARDS patients treated with extracorporeal membrane oxygenation (ECMO). In a prospective cohort study, serum N-terminal procollagen I-peptide (PINP) and N-terminal procollagen III-peptide (PIIINP) concentrations in twenty-three consecutive patients with severe ARDS treated with ECMO were measured at the time of ECMO initiation and during the course of treatment. The predictive value of PINP and PIIINP at the time of ECMO initiation was tested with a univariable logistic regression and a receiver operating characteristic (ROC) curve analysis. Thirteen patients survived to intensive care unit (ICU) discharge. Non-survivors had higher serum PINP and PIIINP concentrations at all points in time during the course of treatment. Serum PIIINP at the day of ECMO initiation showed an odds ratio of 1.37 (95% CI 1.10-1.89, = 0.017) with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.87 (95% CI 0.69-1.00, = 0.0029) for death during the course of treatment. PINP and PIIINP concentrations differ between survivors and non-survivors in ARDS treated with ECMO. This exploratory hypothesis generating study suggests an association between PIIINP serum concentrations at ECMO initiation and an unfavorable clinical outcome.
前胶原肽与急性呼吸窘迫综合征（ARDS）患者的肺纤维增生及不良预后相关。因此，血清前胶原浓度可能对接受体外膜肺氧合（ECMO）治疗的ARDS患者具有预后价值。在一项前瞻性队列研究中，对连续23例接受ECMO治疗的重度ARDS患者在ECMO启动时及治疗过程中测定血清I型前胶原N端肽（PINP）和III型前胶原N端肽（PIIINP）浓度。采用单变量逻辑回归和受试者工作特征（ROC）曲线分析检验ECMO启动时PINP和PIIINP的预测价值。13例患者存活至重症监护病房（ICU）出院。在治疗过程中的所有时间点，非存活者的血清PINP和PIIINP浓度均较高。ECMO启动当天的血清PIIINP显示治疗过程中死亡的比值比为1.37（95%CI 1.10 - 1.89，P = 0.017），受试者工作特征（ROC）曲线下面积（AUC）为0.87（95%CI 0.69 - 1.00，P = 0.0029）。在接受ECMO治疗的ARDS患者中，存活者和非存活者的PINP和PIIINP浓度存在差异。这项探索性的假设生成研究表明，ECMO启动时PIIINP血清浓度与不良临床结局之间存在关联。
