Biomarkers in medicine, Volume 13, Issue 13, 23 September 2019, Pages 1081-1091 Perioperative proADM-change is associated with the development of acute respiratory distress syndrome in critically ill cardiac surgery patients: a prospective cohort study. van Paassen J, van Dissel JT, Hiemstra PS, Zwaginga JJ, Cobbaert CM, Juffermans NP, de Wilde RB, Stijnen T, de Jonge E, Klautz RJ, Arbous MS
Biomarkers of acute respiratory distress syndrome (ARDS) after cardiac-surgery may help risk-stratification and management. Preoperative single-value proADM increases predictive capacity of scoring-system EuroSCORE. To include the impact of surgery, we aim to assess the predictive value of the perioperative proADM-change on development of ARDS in 40 cardiac-surgery patients. Materials & methods
ProADM was measured in nine sequential blood samples. The Berlin definition of ARDS was used. For data-analyses, a multivariate model of EuroSCORE and perioperative proADM-change, linear mixed models and logistic regression were used. Results
Perioperative proADM-change was associated with ARDS after cardiac-surgery, and it was superior to EuroSCORE. A perioperative proADM-change >1.5 nmol/l could predict ARDS. Conclusion
Predicting post-surgery ARDS with perioperative proADM-change enables clinicians to intensify lung-protective interventions and individualized fluid therapy to minimize secondary injury.
Keywords: Prediction, Biomarker, ARDS, Cardiac surgery, Intensive Care, Outcome, Clinical Scoring System, Proadm