Abstract:
BACKGROUND:Heterogeneity of acute respiratory distress syndrome (ARDS) could be reduced by identification of biomarker-based phenotypes. The set of ARDS biomarkers to prospectively define these phenotypes remains to be established. OBJECTIVE:To provide an overview of the biomarkers that were multivariately associated with ARDS development or mortality. DATA SOURCES:We performed a systematic search in Embase, MEDLINE, Web of Science, Cochrane CENTRAL, and Google Scholar from inception until 6 March 2020. STUDY SELECTION:Studies assessing biomarkers for ARDS development in critically ill patients at risk for ARDS and mortality due to ARDS adjusted in multivariate analyses were included. DATA EXTRACTION AND SYNTHESIS:We included 35 studies for ARDS development (10,667 patients at risk for ARDS) and 53 for ARDS mortality (15,344 patients with ARDS). These studies were too heterogeneous to be used in a meta-analysis, as time until outcome and the variables used in the multivariate analyses varied widely between studies. After qualitative inspection, high plasma levels of angiopoeitin-2 and receptor for advanced glycation end products (RAGE) were associated with an increased risk of ARDS development. None of the biomarkers (plasma angiopoeitin-2, C-reactive protein, interleukin-8, RAGE, surfactant protein D, and Von Willebrand factor) was clearly associated with mortality. CONCLUSIONS:Biomarker data reporting and variables used in multivariate analyses differed greatly between studies. Angiopoeitin-2 and RAGE in plasma were positively associated with increased risk of ARDS development. None of the biomarkers independently predicted mortality. Therefore, we suggested to structurally investigate a combination of biomarkers and clinical parameters in order to find more homogeneous ARDS phenotypes. PROSPERO IDENTIFIER:PROSPERO, CRD42017078957.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
van der Zee P,Rietdijk W,Somhorst P,Endeman H,Gommers Ddoi
10.1186/s13054-020-02913-7subject
Has Abstractpub_date
2020-05-24 00:00:00pages
243issue
1eissn
1364-8535issn
1466-609Xpii
10.1186/s13054-020-02913-7journal_volume
24pub_type
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