Abstract
Acute respiratory distress syndrome (ARDS) is an acute inflammation of the lung resulting from damage to the alveolar–capillary membrane, and it is diagnosed using a combination of clinical and physiological variables. ARDS develops in approximately 10% of hospitalised patients with pneumonia and has a mortality rate of approximately 40%. Recent research has identified several biomarkers associated with ARDS pathophysiology, and these may be useful for diagnosing and monitoring ARDS. They may also highlight potential therapeutic targets. This review summarises our current understanding of those clinical biomarkers: (1) biomarkers of alveolar and bronchiolar injury, (2) biomarkers of endothelial damage and coagulation, and (3) biomarkers for treatment responses.
Highlights
Acute respiratory distress syndrome (ARDS) is characterised by uncontrolled inflammation and damage to endothelial and epithelial barriers of the lung
This has been shown in several studies, e.g., high levels of Surfactant protein D (SP-D) within 48 h after intensive care unit (ICU) admission (N = 407) might serve as a diagnostic marker for ARDS in patients hospitalised in medical ICU [11] and patients with severe sepsis (N =100) [12]
Plasma levels of Soluble receptor for advanced glycation end products (sRAGE) could not predict ARDS in 129 patients with severe sepsis [23], nor in 230 critically ill patients [24]; higher levels of sRAGE predicted ARDS in a multicentre, prospective observational cohort study of 464 critically ill patients [25], and sRAGE was associated with mortality in a meta-analysis of 746 patients with ARDS based on eight trials; one large Randomised Controlled Trial (RCT)-based cohort, four non-RCT based cohorts, and three case-control studies [26]
Summary
Acute respiratory distress syndrome (ARDS) is characterised by uncontrolled inflammation and damage to endothelial and epithelial barriers of the lung. Biomarkers may be useful for identifying ARDS, stratifying risks, and predicting specific outcomes (e.g., mortality). They may be used for assessing the severity of illnesses, revealing prognoses, and monitoring responses to therapy. Plasma SP-D levels can be helpful to diagnose ARDS [11], because patients with ARDS exhibit an increase in SP-D levels, which peaks between days 3 and 7 of the illness [6] This has been shown in several studies, e.g., high levels of SP-D within 48 h after intensive care unit (ICU) admission (N = 407) might serve as a diagnostic marker for ARDS in patients hospitalised in medical ICU [11] and patients with severe sepsis (N =100) [12]. Plasma SP-D appears to be a promising biomarker in ARDS
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