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Critical Care
Published in: Critical Care 1/2020

Open Access 01-12-2020 | Acute Respiratory Distress-Syndrome | Research

A systematic review of biomarkers multivariately associated with acute respiratory distress syndrome development and mortality

Authors: Philip van der Zee, Wim Rietdijk, Peter Somhorst, Henrik Endeman, Diederik Gommers

Published in: Critical Care | Issue 1/2020

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Abstract

Background

Heterogeneity of acute respiratory distress syndrome (ARDS) could be reduced by identification of biomarker-based phenotypes. The set of ARDS biomarkers to prospectively define these phenotypes remains to be established.

Objective

To provide an overview of the biomarkers that were multivariately associated with ARDS development or mortality.

Data sources

We performed a systematic search in Embase, MEDLINE, Web of Science, Cochrane CENTRAL, and Google Scholar from inception until 6 March 2020.

Study selection

Studies assessing biomarkers for ARDS development in critically ill patients at risk for ARDS and mortality due to ARDS adjusted in multivariate analyses were included.

Data extraction and synthesis

We included 35 studies for ARDS development (10,667 patients at risk for ARDS) and 53 for ARDS mortality (15,344 patients with ARDS). These studies were too heterogeneous to be used in a meta-analysis, as time until outcome and the variables used in the multivariate analyses varied widely between studies. After qualitative inspection, high plasma levels of angiopoeitin-2 and receptor for advanced glycation end products (RAGE) were associated with an increased risk of ARDS development. None of the biomarkers (plasma angiopoeitin-2, C-reactive protein, interleukin-8, RAGE, surfactant protein D, and Von Willebrand factor) was clearly associated with mortality.

Conclusions

Biomarker data reporting and variables used in multivariate analyses differed greatly between studies. Angiopoeitin-2 and RAGE in plasma were positively associated with increased risk of ARDS development. None of the biomarkers independently predicted mortality. Therefore, we suggested to structurally investigate a combination of biomarkers and clinical parameters in order to find more homogeneous ARDS phenotypes.

PROSPERO identifier

PROSPERO, CRD42017078957
Appendix
Available only for authorised users
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Metadata
Title
A systematic review of biomarkers multivariately associated with acute respiratory distress syndrome development and mortality
Authors
Philip van der Zee
Wim Rietdijk
Peter Somhorst
Henrik Endeman
Diederik Gommers
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-020-02913-7

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Mortality in sepsis and septic shock in Europe, North America and Australia between 2009 and 2019— results from a systematic review and meta-analysis

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Naloxone should remain the appropriate antidote to treat opioid overdose

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High-flow nasal cannula can’t be considered non-inferior to noninvasive ventilation in patients with chronic obstructive pulmonary disease who develop respiratory failure after extubation

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Lactate dehydrogenase elevations is associated with severity of COVID-19: a meta-analysis

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Iodinated contrast medium: Is there a re(n)al problem? A clinical vignette-based review