Screening study of peripheral blood biomarkers in sepsis-associated ARDS

Abstract

Objective: Acute respiratory distress syndrome (ARDS) is a serious and rapidly progressive complication of sepsis with a very high mortality rate. Screening for reliable biomarkers can assist in the diagnosis and treatment of the disease, and the development of personalized immunotherapy regimens may provide great clinical benefit. Method: The clinical data of 110 patients with sepsis treated in our medical unit from November 2018 to January 2020 were reviewed through a single-center retrospective analytic study. Using the Statistical Package for Social Science (SPSS, version 26) and the software GraphPad Prism 7, statistical analyses were performed and graphs were generated. Mean (standard deviation [SD]) and median (interquartile range [IQR]) should be used for description of normally and non-normally distributed data, respectively. The normal and non-normal distributed quantitative variables were respectively assessed by independent T-test or Chi-square test. P-value <0. 05 noted statistical significance. Results: (1) Finally, 32 patients were enrolled in the study, among 32 patients with sepsis-associated ARDS, there were 13 cases in the survival group and 19 cases in the death group. There were 10 males and 3 females in the survival group, with an age of 61. 77±14. 296 years. There were 13 males and 6 females in the death group, with an age of 66. 11±11. 455 years. There was no statistically significant difference between the two groups in terms of age and gender (P>0. 05). (2) The difference in PaO2/FiO2 between the two groups was statistically significant (P<0. 05). Their AUC was 0. 8057, and the sensitivity and specificity were 89. 47% and 69. 23% respectively. (3) By comparison of median scatter plots, cytokines IL-6, IL-6/IL-10, admission NLR, and discharge NLR were higher in the death group compared with survival. IL-10 and IFN-γ were lower compared with survival. (4) The results of logistic regression analysis showed risk factors affecting the prognosis of sepsis-associated ARDS:PaO2/FiO2 (P=0. 019, OR:12. 289, 95% CI:1. 512 - 99. 8);Protective factor: IFN-γ(P=0. 03, OR:0. 161, 95% CI:0. 031 - 0. 834 ). Conclusion: (1) PaO2/FiO2 can be used to assess the prognosis of septic ARDS patients; (2) cytokine assay may be a guide to determine the prognosis of septic ARDS; (3) IFN-γmay be a protective factor in the course of septic ARDS patients.