Perioperative proADM-change is associated with the development of acute respiratory distress syndrome in critically ill cardiac surgery patients: a prospective cohort study

Paassen, J.; Dissel, J.T. van; Hiemstra, P.S.; Zwaginga, J.J.; Cobbaert, C.M.; Juffermans, N.P.; ... ; Arbous, M.S. (2019)

Article / Letter to editor

Aim: 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.

• ARDS
• biomarker
• cardiac surgery
• clinical scoring system
• intensive care
• outcome
• prediction
• ProADM

• All authors: Paassen, J.; Dissel, J.T. van; Hiemstra, P.S.; Zwaginga, J.J.; Cobbaert, C.M.; Juffermans, N.P.; Wilde, R.B. de; Stijnen, T.; Jonge, E. de; Klautz, R.J.; Arbous, M.S.
• Date: 2019-09-01
• Journal: Biomarkers in Medicine
• Volume: 13
• Issue: 13
• Pages: 1081 - 1091
• DOI: doi:10.2217/bmm-2019-0028