Soluble intercellular adhesion molecule-1 and clinical outcomes in patients with acute lung injury
Carolyn S Calfee, Mark D Eisner, Polly E Parsons, B Taylor Thompson, Edward R Conner Jr, Michael A Matthay, Lorraine B Ware, NHLBI Acute Respiratory Distress Syndrome Clinical Trials Network, Herbert P Wiedemann, Alejandro C Arroliga, Charles J Fisher Jr, John J Komara Jr, Patricia Periz-Trepichio, Polly E Parsons, Carolyn Welsh, William J Fulkerson Jr, Neil MacIntyre, Lee Mallatratt, Mark Sebastian, John Davies, Elizabeth Van Dyne, Joseph Govert, Jonathan Sevransky, Stacey Murray, Roy G Brower, David Thompson, Henry E Fessler, Alan H Morris, Terry Clemmer, Robin Davis, James Orme Jr, Lindell Weaver, Colin Grissom, Frank Thomas, Martin Gleich, Charles Lawton, Janice D'Hulst, Joel R Peerless, Carolyn Smith, Richard Kallet, John M Luce, Jonathan Gottlieb, Pauline Park, Aimee Girod, Lisa Yannarell, Michael A Matthay, Mark D Eisner, Brian Daniel, Edward Abraham, Fran Piedalue, Rebecca Jagusch, Paul Miller, Robert McIntyre, Kelley E Greene, Henry J Silverman, Carl Shanholtz, Wanda Corral, Galen B Toews, Deborah Arnoldi, Robert H Bartlett, Ron Dechert, Charles Watts, Paul N Lanken, Harry Anderson 3rd, Barbara Finkel, C William Hanson 3rd, Richard Barton, Mary Mone, Leonard D Hudson, Greg Carter, Claudette L Cooper, Annemieke Hiemstra, Ronald V Maier, Kenneth P Steinberg, Tracy Hill, Phil Thaut, Arthur P Wheeler, Gordon Bernard, Brian Christman, Susan Bozeman, Linda Collins, Teresa Swope, Lorraine B Ware, David A Schoenfeld, B Taylor Thompson, Marek Ancukiewicz, Douglas Hayden, Francine Molay, Nancy Ringwood, Gail Wenzlow, Ali S Kazeroonin, Dorothy B Gail, Andrea Harabin, Pamela Lew, Myron Waclawiw, Gordon R Bernard, Roger G Spragg, James Boyett, Jason Kelley, Kenneth Leeper, Marion Gray Secundy, Arthur Slutsky, Joe G N Garcia, Scott S Emerson, Susan K Pingleton, Michael D Shasby, William J Sibbald, Carolyn S Calfee, Mark D Eisner, Polly E Parsons, B Taylor Thompson, Edward R Conner Jr, Michael A Matthay, Lorraine B Ware, NHLBI Acute Respiratory Distress Syndrome Clinical Trials Network, Herbert P Wiedemann, Alejandro C Arroliga, Charles J Fisher Jr, John J Komara Jr, Patricia Periz-Trepichio, Polly E Parsons, Carolyn Welsh, William J Fulkerson Jr, Neil MacIntyre, Lee Mallatratt, Mark Sebastian, John Davies, Elizabeth Van Dyne, Joseph Govert, Jonathan Sevransky, Stacey Murray, Roy G Brower, David Thompson, Henry E Fessler, Alan H Morris, Terry Clemmer, Robin Davis, James Orme Jr, Lindell Weaver, Colin Grissom, Frank Thomas, Martin Gleich, Charles Lawton, Janice D'Hulst, Joel R Peerless, Carolyn Smith, Richard Kallet, John M Luce, Jonathan Gottlieb, Pauline Park, Aimee Girod, Lisa Yannarell, Michael A Matthay, Mark D Eisner, Brian Daniel, Edward Abraham, Fran Piedalue, Rebecca Jagusch, Paul Miller, Robert McIntyre, Kelley E Greene, Henry J Silverman, Carl Shanholtz, Wanda Corral, Galen B Toews, Deborah Arnoldi, Robert H Bartlett, Ron Dechert, Charles Watts, Paul N Lanken, Harry Anderson 3rd, Barbara Finkel, C William Hanson 3rd, Richard Barton, Mary Mone, Leonard D Hudson, Greg Carter, Claudette L Cooper, Annemieke Hiemstra, Ronald V Maier, Kenneth P Steinberg, Tracy Hill, Phil Thaut, Arthur P Wheeler, Gordon Bernard, Brian Christman, Susan Bozeman, Linda Collins, Teresa Swope, Lorraine B Ware, David A Schoenfeld, B Taylor Thompson, Marek Ancukiewicz, Douglas Hayden, Francine Molay, Nancy Ringwood, Gail Wenzlow, Ali S Kazeroonin, Dorothy B Gail, Andrea Harabin, Pamela Lew, Myron Waclawiw, Gordon R Bernard, Roger G Spragg, James Boyett, Jason Kelley, Kenneth Leeper, Marion Gray Secundy, Arthur Slutsky, Joe G N Garcia, Scott S Emerson, Susan K Pingleton, Michael D Shasby, William J Sibbald
Abstract
Objective: To determine if levels of soluble intercellular adhesion molecule-1 (sICAM-1), a marker of alveolar epithelial and endothelial injury, differ in patients with hydrostatic pulmonary edema and acute lung injury (ALI) and are associated with clinical outcomes in patients with ALI.
Design, setting, and participants: Measurement of sICAM-1 levels in (1) plasma and edema fluid from 67 patients with either hydrostatic pulmonary edema or ALI enrolled in an observational, prospective single center study, and (2) in plasma from 778 patients with ALI enrolled in a large multi-center randomized controlled trial of ventilator strategy.
Results: In the single-center study, levels of sICAM-1 were significantly higher in both edema fluid and plasma (median 938 and 545 ng/ml, respectively) from ALI patients compared to hydrostatic edema patients (median 384 and 177 ng/ml, P < 0.03 for both comparisons). In the multi-center study, higher plasma sICAM-1 levels were associated with poor clinical outcomes in both unadjusted and multivariable models. Subjects with ALI whose plasma sICAM-1 levels increased over the first 3 days of the study had a higher risk of death, after adjusting for other important predictors of outcome (odds ratio 1.48; 95% CI 1.03-2.12, P = 0.03).
Conclusions: Both plasma and edema fluid levels of sICAM-1 are higher in patients with ALI than in patients with hydrostatic pulmonary edema. Higher plasma sICAM-1 levels and increasing sICAM-1 levels over time are associated with poor clinical outcomes in ALI. Measurement of sICAM-1 levels may be useful for identifying patients at highest risk of poor outcomes from ALI.
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Source: PubMed