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ABSTRACT: Background
Elevated surfactant protein D (SP-D) is a relatively specific indicator of lung injury and is associated with both acute and chronic lung disease in adults and respiratory distress syndrome in premature infants. The relationship between plasma SP-D and lung injury in children with acute respiratory failure is unclear.Research question
Is plasma SP-D associated with lung injury or outcome in children with acute respiratory failure?Study design and methods
This was a prospective cohort study in children 2 weeks to 17 years of age with acute respiratory failure who participated in the BALI multi-center study. Analyses were done using SP-D levels in plasma from the first sample taken on either the day of intubation or one of the following 2 days. SP-D level was measured by enzyme-linked immunosorbent assay.Results
Plasma samples from 350 patients were used in the analysis; 233 had pediatric ARDS (PARDS). SP-D levels varied across primary diagnoses (P < .001). Elevated SP-D levels were associated with severe PARDS after adjusting for age, pediatric risk of mortality III (PRISM-III), and primary diagnosis (OR = 1.02; CI = 1.01-1.04; P = .011). Multivariable analyses also indicated that elevated SP-D levels were associated with death (OR = 1.02; CI = 1.01-1.04; P = .004), duration of mechanical ventilation (P = .012), PICU length of stay (P = .019), and highest oxygenation index (P = .040). SP-D levels also correlated with age (rs = 0.16, P = .002).Interpretation
Elevated plasma SP-D levels are associated with severe PARDS and poor outcomes in children with acute respiratory failure. Future studies will determine whether SP-D can be used to predict the degree of lung injury or response to treatment and whether SP-D is useful in identifying PARDS endotypes.
SUBMITTER: Dahmer MK
PROVIDER: S-EPMC7478231 | biostudies-literature | 2020 Sep
REPOSITORIES: biostudies-literature
Dahmer Mary K MK Flori Heidi H Sapru Anil A Kohne Joseph J Weeks Heidi M HM Curley Martha A Q MAQ Matthay Michael A MA Quasney Michael W MW
Chest 20200408 3
<h4>Background</h4>Elevated surfactant protein D (SP-D) is a relatively specific indicator of lung injury and is associated with both acute and chronic lung disease in adults and respiratory distress syndrome in premature infants. The relationship between plasma SP-D and lung injury in children with acute respiratory failure is unclear.<h4>Research question</h4>Is plasma SP-D associated with lung injury or outcome in children with acute respiratory failure?<h4>Study design and methods</h4>This w ...[more]