Elevated levels of soluble RAGE predict impaired alveolar fluid clearance in a translational mouse model of acute respiratory distress syndrome

R Blondonnet,JM Constantin,M Jabaudon,P Dechelotte,D Bouvier,G Clairefond,G Marceau,P Blanc,V Sapin,J Audard

doi:10.1186/cc14317

Abstract

Receptor for advanced glycation endproducts (RAGE) is a transmembrane receptor expressed in the lung and primarily located on alveolar type I cells. RAGE is implicated in acute respiratory distress syndrome to alveolar inflammation and, when its soluble form sRAGE is assayed in plasma or pulmonary edema fluid, as a marker of AT I cell injury. Functional activity of AT 1 cells can be assessed by the measurement of the alveolar fluid clearance (AFC) rate [1], but the relationship between sRAGE plasma levels of sRAGE and AFC rates has never been investigated. Our objectives were to report plasma levels of sRAGE in a mouse model of direct acid-induced epithelial injury, and to test their correlation with AFC rates.

Highlights

To assess cerebral hemodynamics in an experimental sepsis model
Healthy bowel function is an important factor when judging the advisability of early enteral nutrition in critically ill patients
Since the Surviving Sepsis Campaign (SSC) in 2002, the Health Service Ombudsman for England published recommendations for improving recognition and treatment of sepsis [2], the Royal College of Physicians issued a toolkit for the management of sepsis in the acute medical unit [3], and NHS England released a patient safety alert to support prompt recognition and treatment of sepsis [4]

Summary

Introduction

We evaluated platelet activation markers as potential predictive markers of sepsis and of mortality among four commonly encountered populations of patients admitted to ICUs. Methods Ninety-nine non-infected ICU patients were prospectively screened at day 1 (T1) and day 3 (T2) of admission after elective cardiac surgery, trauma, acute neurologic dysfunction or prolonged ventilation (>48 hours). The present study was performed with the aim of assessing whether nursing and physician staff were able to identify patients in need of critical care using only clinical judgment and to compare this with the National Early Warning Score (NEWS) Methods This was a prospective cohort study of all adult patients with a first-time admission to a medical admission unit at a 450-bed regional teaching hospital over a 3-month period in 2010.

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