Background
Methods
Study population
Measurement of HA
Statistical analysis
Results
Characteristic | Values in patients (n = 86) |
---|---|
Age (years), mean ± SD | 50 ± 17 |
Male sex, n (%) | 54 (63) |
Race, n (%) | |
White | 76 (88) |
African American | 3 (4) |
Othera
| 7 (8) |
Co-morbidities, n (%) | |
Fish oil treatment, n (%) | 38 (44) |
Diabetes mellitus | 18 (21) |
Liver cirrhosis | 6 (7) |
Chronic kidney disease | 2 (2) |
ARDS risk factor, n (%) | |
Direct
b
| 47 (55) |
Indirect
c
| 39 (45) |
ARDS classification of severityd,e, n (%) | |
Mild | 25 (29) |
Moderate | 49 (57) |
Severe | 10 (12) |
APACHE II score, mean ± SD | 22 ± 6 |
Sepsis, n (%) | 56 (65) |
Day-0 serum HA (ng/mL), median (IQR) | 125.85 (55.81–241.58) |
Day-0 BALF HA (ng/mL), median (IQR)f
| 62.00 (20.78–215.95) |
Lung injury score, mean ± SD | 3 ± 1 |
Sequential organ failure assessment score, mean ± SDg
| 9 ± 4 |
28-Day mortality, n (%) | 13 (15) |
HA levels are associated with measures of local organ injury
Outcome | Source | β (95% CI)a
|
p
| β (95% CI)b
|
p
|
---|---|---|---|---|---|
Lung injury score | Serum | 0.35 (0.05–0.65) | 0.02 | 0.30 (0.02–0.57) | 0.04 |
BALFc
| 0.31 (0.11–0.50) | 0.002 | 0.27 (0.09–0.45) | 0.003 | |
Ventilator-free daysd
| Serum | -0.59 (-1.21–0.03) | 0.06 | -0.47 (-1.10–0.15) | 0.14 |
BALFc
| -0.09 (-0.51–0.33) | 0.67 | -0.15 (-0.58–0.27) | 0.47 | |
SOFAe
| Serum | 3.89 (2.18–5.61) | <0.001 | 4.02 (2.30–5.74) | <0.001 |
BALFc
| 0.42 (-0.85–1.69) | 0.52 | 0.72 (-0.56–2.00) | 0.27 |
Lung injury score componenta
| Source | β (95% CI)b
|
p
| β (95% CI)c
|
p
|
---|---|---|---|---|---|
Chest radiographd
| Serum | -0.15 (-0.54–0.24) | 0.44 | -0.25 (-0.63–0.14) | 0.21 |
BALFe
| -0.05 (-0.30–0.20) | 0.69 | -0.08 (-0.33–0.17) | 0.53 | |
Hypoxemiaf
| Serum | 0.66 (0.19–1.12) | 0.006 | 0.57 (0.11–1.03) | 0.02 |
BALFe
| 0.57 (0.28–0.86) | <0.001 | 0.56 (0.28–0.85) | <0.001 | |
Positive end-expiratory pressure | Serum | 0.77 (0.16–1.38) | 0.01 | 0.76 (0.16–1.35) | 0.01 |
BALFe
| 0.57 (0.17–0.96) | 0.006 | 0.46 (0.07–0.85) | 0.02 | |
Respiratory system complianceg
| Serum | 0.005 (-0.35–0.36) | 0.98 | 0.02 (-0.31–0.36) | 0.89 |
BALFe
| 0.09 (-0.14–0.32) | 0.43 | 0.04 (-0.17–0.26) | 0.69 |
HA levels are associated with measures of organ dysfunction
SOFA componenta
| Source | β (95% CI)b
|
p
| β (95% CI)c
|
p
|
---|---|---|---|---|---|
Respiratory | Serum | 0.45 (0.10–0.80) | 0.01 | 0.42 (0.06–0.78) | 0.02 |
BALFd
| 0.37 (0.14–0.60) | 0.002 | 0.36 (0.13–0.60) | 0.003 | |
Coagulation | Serum | 0.93 (0.48–1.37) | <0.001 | 1.04 (0.60–1.47) | <0.001 |
BALFd
| -0.12 (-0.44–0.20) | 0.45 | -0.08 (-0.40–0.25) | 0.65 | |
Livere
| Serum | 0.77 (0.21–1.34) | 0.007 | 0.78 (0.22–1.33) | 0.006 |
BALFd
| -0.02 (-0.44–0.20) | 0.93 | 0.08 (-0.30–0.54) | 0.69 | |
Cardiovascular | Serum | 0.79 (-0.01–1.60) | >0.05 | 0.70 (-0.12–1.5) | 0.09 |
BALFd
| 0.22 (-0.32–0.76) | 0.42 | 0.30 (-0.24–0.85) | 0.27 | |
Neurologic | Serum | 0.31 (-0.34–0.96) | 0.34 | 0.44 (-0.21–1.1) | 0.18 |
BALFd
| 0.01 (-0.42–0.44) | 0.95 | 0.09 (-0.35–0.52) | 0.69 | |
Renal | Serum | 0.60 (0.16–1.05) | 0.01 | 0.57 (0.12–1.02) | 0.014 |
BALFd
| -0.08 (-0.39–0.23) | 0.60 | -0.05 (-0.36–0.26) | 0.74 |