Inflammatory Biomarkers Are Associated With a Decline in Functional Status at Discharge in Children With Acute Respiratory Failure: An Exploratory Analysis
OBJECTIVES:. To evaluate the link between early acute respiratory failure and functional morbidity in survivors using the plasma biomarkers interleukin-8, interleukin-1 receptor antagonist, thrombomodulin, and plasminogen activator inhibitor-1. We hypothesized that children with acute respiratory fa...
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Wolters Kluwer
2021
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Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 |
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Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Erin F. Carlton, MD, MSc Heidi M. Weeks, PhD Mary K. Dahmer, PhD Michael W. Quasney, MD, PhD Anil Sapru, MD, MAS Martha A.Q. Curley, PhD, RN Heidi R. Flori, MD for the BALI and RESTORE Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Heidi Flori Michael W. Quasney Mary K. Dahmer Anil Sapru Martha Curley Michael A. Matthay Scot T. Bateman M. D. Berg Santiago Borasino G. Kris Bysani Allison S. Cowl Cindy Darnell Bowens E. Vincent S. Faustino Lori D. Fineman A. J. Godshall Ellie Hirshberg Aileen L. Kirby Gwenn E. McLaughlin Shivanand Medar Phineas P. Oren James B. Schneider Adam J. Schwarz Thomas P. Shanley Lauren R. Source Edward J. Truemper Michele A. Vander Heyden Kim Wittmayer Athena Zuppa David Wypij Martha A. Q. Curley David Wypij Geoffrey L. Allen Derek C. Angus Lisa A. Asaro Judy A. Ascenzi Scot T. Bateman Santiago Borasino Cindy Darnell Bowens G. Kris Bysani Ira M. Cheifetz Allison S. Cowl Brenda L. Dodson E. Vincent S. Faustino Lori D. Fineman Heidi R. Flori Linda S. Franck Rainer G. Gedeit Mary Jo C. Grant Andrea L. Harabin Catherine Haskins-Kiefer James H. Hertzog Larissa Hutchins Aileen L. Kirby Ruth M. Lebet Michael A. Matthay Gwenn E. McLaughlin JoAnne E. Natale Phineas P. Oren Nagendra Polavarapu James B. Schneider Adam J. Schwarz Thomas P. Shanley Shari Simone Lewis P. Singer Lauren R. Source Edward J. Truemper Michele A. Vander Heyden R. Scott Watson Claire R. Wells Inflammatory Biomarkers Are Associated With a Decline in Functional Status at Discharge in Children With Acute Respiratory Failure: An Exploratory Analysis |
| description |
OBJECTIVES:. To evaluate the link between early acute respiratory failure and functional morbidity in survivors using the plasma biomarkers interleukin-8, interleukin-1 receptor antagonist, thrombomodulin, and plasminogen activator inhibitor-1. We hypothesized that children with acute respiratory failure with higher levels of inflammation would have worse functional outcomes at discharge, as measured by Pediatric Overall Performance Category.
DESIGN:. Secondary analysis of the Genetic Variation and Biomarkers in Children with Acute Lung Injury (R01HL095410) study.
SETTING:. Twenty-two PICUs participating in the multisite clinical trial, Randomized Evaluation of Sedation Titration for Respiratory Failure (U01 HL086622) and the ancillary study (Biomarkers in Children with Acute Lung Injury).
SUBJECTS:. Children 2 weeks to 17 years requiring invasive mechanical ventilation for acute airways and/or parenchymal lung disease. Patients with an admission Pediatric Overall Performance Category greater than 3 (severe disability, coma, or brain death) were excluded.
INTERVENTIONS:. None.
MEASUREMENTS AND MAIN RESULTS:. Among survivors, 387 patients had no worsening of Pediatric Overall Performance Category at discharge while 40 had worsening functional status, defined as any increase in Pediatric Overall Performance Category from baseline. There was no significant relationship between worsening of Pediatric Overall Performance Category and interleukin-8 or plasminogen activator inhibitor-1 on any day. There was no significant relationship between interleukin-1 receptor antagonist, or thrombomodulin, and worsening Pediatric Overall Performance Category on day 1. Plasma interleukin-1 receptor antagonist and thrombomodulin were significantly elevated on days 2 and 3 in those with worse functional status at discharge compared with those without. In multivariable analysis, interleukin-1 receptor antagonist and thrombomodulin were associated with a decline in functional status on days 2 and 3 after adjustment for age and highest oxygenation index. However, after adjusting for age and cardiovascular failure, only day 2 thrombomodulin levels were associated with a worsening in Pediatric Overall Performance Category.
CONCLUSIONS:. Higher levels of interleukin-1 receptor antagonist or thrombomodulin following intubation were associated with worse Pediatric Overall Performance Category scores at hospital discharge in children who survive acute respiratory failure. These data suggest that persistent inflammation may be related to functional decline. |
| format |
article |
| author |
Erin F. Carlton, MD, MSc Heidi M. Weeks, PhD Mary K. Dahmer, PhD Michael W. Quasney, MD, PhD Anil Sapru, MD, MAS Martha A.Q. Curley, PhD, RN Heidi R. Flori, MD for the BALI and RESTORE Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Heidi Flori Michael W. Quasney Mary K. Dahmer Anil Sapru Martha Curley Michael A. Matthay Scot T. Bateman M. D. Berg Santiago Borasino G. Kris Bysani Allison S. Cowl Cindy Darnell Bowens E. Vincent S. Faustino Lori D. Fineman A. J. Godshall Ellie Hirshberg Aileen L. Kirby Gwenn E. McLaughlin Shivanand Medar Phineas P. Oren James B. Schneider Adam J. Schwarz Thomas P. Shanley Lauren R. Source Edward J. Truemper Michele A. Vander Heyden Kim Wittmayer Athena Zuppa David Wypij Martha A. Q. Curley David Wypij Geoffrey L. Allen Derek C. Angus Lisa A. Asaro Judy A. Ascenzi Scot T. Bateman Santiago Borasino Cindy Darnell Bowens G. Kris Bysani Ira M. Cheifetz Allison S. Cowl Brenda L. Dodson E. Vincent S. Faustino Lori D. Fineman Heidi R. Flori Linda S. Franck Rainer G. Gedeit Mary Jo C. Grant Andrea L. Harabin Catherine Haskins-Kiefer James H. Hertzog Larissa Hutchins Aileen L. Kirby Ruth M. Lebet Michael A. Matthay Gwenn E. McLaughlin JoAnne E. Natale Phineas P. Oren Nagendra Polavarapu James B. Schneider Adam J. Schwarz Thomas P. Shanley Shari Simone Lewis P. Singer Lauren R. Source Edward J. Truemper Michele A. Vander Heyden R. Scott Watson Claire R. Wells |
| author_facet |
Erin F. Carlton, MD, MSc Heidi M. Weeks, PhD Mary K. Dahmer, PhD Michael W. Quasney, MD, PhD Anil Sapru, MD, MAS Martha A.Q. Curley, PhD, RN Heidi R. Flori, MD for the BALI and RESTORE Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Heidi Flori Michael W. Quasney Mary K. Dahmer Anil Sapru Martha Curley Michael A. Matthay Scot T. Bateman M. D. Berg Santiago Borasino G. Kris Bysani Allison S. Cowl Cindy Darnell Bowens E. Vincent S. Faustino Lori D. Fineman A. J. Godshall Ellie Hirshberg Aileen L. Kirby Gwenn E. McLaughlin Shivanand Medar Phineas P. Oren James B. Schneider Adam J. Schwarz Thomas P. Shanley Lauren R. Source Edward J. Truemper Michele A. Vander Heyden Kim Wittmayer Athena Zuppa David Wypij Martha A. Q. Curley David Wypij Geoffrey L. Allen Derek C. Angus Lisa A. Asaro Judy A. Ascenzi Scot T. Bateman Santiago Borasino Cindy Darnell Bowens G. Kris Bysani Ira M. Cheifetz Allison S. Cowl Brenda L. Dodson E. Vincent S. Faustino Lori D. Fineman Heidi R. Flori Linda S. Franck Rainer G. Gedeit Mary Jo C. Grant Andrea L. Harabin Catherine Haskins-Kiefer James H. Hertzog Larissa Hutchins Aileen L. Kirby Ruth M. Lebet Michael A. Matthay Gwenn E. McLaughlin JoAnne E. Natale Phineas P. Oren Nagendra Polavarapu James B. Schneider Adam J. Schwarz Thomas P. Shanley Shari Simone Lewis P. Singer Lauren R. Source Edward J. Truemper Michele A. Vander Heyden R. Scott Watson Claire R. Wells |
| author_sort |
Erin F. Carlton, MD, MSc |
| title |
Inflammatory Biomarkers Are Associated With a Decline in Functional Status at Discharge in Children With Acute Respiratory Failure: An Exploratory Analysis |
| title_short |
Inflammatory Biomarkers Are Associated With a Decline in Functional Status at Discharge in Children With Acute Respiratory Failure: An Exploratory Analysis |
| title_full |
Inflammatory Biomarkers Are Associated With a Decline in Functional Status at Discharge in Children With Acute Respiratory Failure: An Exploratory Analysis |
| title_fullStr |
Inflammatory Biomarkers Are Associated With a Decline in Functional Status at Discharge in Children With Acute Respiratory Failure: An Exploratory Analysis |
| title_full_unstemmed |
Inflammatory Biomarkers Are Associated With a Decline in Functional Status at Discharge in Children With Acute Respiratory Failure: An Exploratory Analysis |
| title_sort |
inflammatory biomarkers are associated with a decline in functional status at discharge in children with acute respiratory failure: an exploratory analysis |
| publisher |
Wolters Kluwer |
| publishDate |
2021 |
| url |
https://doaj.org/article/61e7200c23f242228904d908a19129f5 |
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oai:doaj.org-article:61e7200c23f242228904d908a19129f52021-11-25T07:55:25ZInflammatory Biomarkers Are Associated With a Decline in Functional Status at Discharge in Children With Acute Respiratory Failure: An Exploratory Analysis2639-802810.1097/CCE.0000000000000467https://doaj.org/article/61e7200c23f242228904d908a19129f52021-07-01T00:00:00Zhttp://journals.lww.com/10.1097/CCE.0000000000000467https://doaj.org/toc/2639-8028OBJECTIVES:. To evaluate the link between early acute respiratory failure and functional morbidity in survivors using the plasma biomarkers interleukin-8, interleukin-1 receptor antagonist, thrombomodulin, and plasminogen activator inhibitor-1. We hypothesized that children with acute respiratory failure with higher levels of inflammation would have worse functional outcomes at discharge, as measured by Pediatric Overall Performance Category. DESIGN:. Secondary analysis of the Genetic Variation and Biomarkers in Children with Acute Lung Injury (R01HL095410) study. SETTING:. Twenty-two PICUs participating in the multisite clinical trial, Randomized Evaluation of Sedation Titration for Respiratory Failure (U01 HL086622) and the ancillary study (Biomarkers in Children with Acute Lung Injury). SUBJECTS:. Children 2 weeks to 17 years requiring invasive mechanical ventilation for acute airways and/or parenchymal lung disease. Patients with an admission Pediatric Overall Performance Category greater than 3 (severe disability, coma, or brain death) were excluded. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Among survivors, 387 patients had no worsening of Pediatric Overall Performance Category at discharge while 40 had worsening functional status, defined as any increase in Pediatric Overall Performance Category from baseline. There was no significant relationship between worsening of Pediatric Overall Performance Category and interleukin-8 or plasminogen activator inhibitor-1 on any day. There was no significant relationship between interleukin-1 receptor antagonist, or thrombomodulin, and worsening Pediatric Overall Performance Category on day 1. Plasma interleukin-1 receptor antagonist and thrombomodulin were significantly elevated on days 2 and 3 in those with worse functional status at discharge compared with those without. In multivariable analysis, interleukin-1 receptor antagonist and thrombomodulin were associated with a decline in functional status on days 2 and 3 after adjustment for age and highest oxygenation index. However, after adjusting for age and cardiovascular failure, only day 2 thrombomodulin levels were associated with a worsening in Pediatric Overall Performance Category. CONCLUSIONS:. Higher levels of interleukin-1 receptor antagonist or thrombomodulin following intubation were associated with worse Pediatric Overall Performance Category scores at hospital discharge in children who survive acute respiratory failure. These data suggest that persistent inflammation may be related to functional decline.Erin F. Carlton, MD, MScHeidi M. Weeks, PhDMary K. Dahmer, PhDMichael W. Quasney, MD, PhDAnil Sapru, MD, MASMartha A.Q. Curley, PhD, RNHeidi R. Flori, MDfor the BALI and RESTORE Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) NetworkHeidi FloriMichael W. QuasneyMary K. DahmerAnil SapruMartha CurleyMichael A. MatthayScot T. BatemanM. D. BergSantiago BorasinoG. Kris BysaniAllison S. CowlCindy Darnell BowensE. Vincent S. FaustinoLori D. FinemanA. J. GodshallEllie HirshbergAileen L. KirbyGwenn E. McLaughlinShivanand MedarPhineas P. OrenJames B. SchneiderAdam J. SchwarzThomas P. ShanleyLauren R. SourceEdward J. TruemperMichele A. Vander HeydenKim WittmayerAthena ZuppaDavid WypijMartha A. Q. CurleyDavid WypijGeoffrey L. AllenDerek C. AngusLisa A. AsaroJudy A. AscenziScot T. BatemanSantiago BorasinoCindy Darnell BowensG. Kris BysaniIra M. CheifetzAllison S. CowlBrenda L. DodsonE. Vincent S. FaustinoLori D. FinemanHeidi R. FloriLinda S. FranckRainer G. GedeitMary Jo C. GrantAndrea L. HarabinCatherine Haskins-KieferJames H. HertzogLarissa HutchinsAileen L. KirbyRuth M. LebetMichael A. MatthayGwenn E. McLaughlinJoAnne E. NatalePhineas P. OrenNagendra PolavarapuJames B. SchneiderAdam J. SchwarzThomas P. ShanleyShari SimoneLewis P. SingerLauren R. SourceEdward J. TruemperMichele A. Vander HeydenR. Scott WatsonClaire R. WellsWolters KluwerarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care Explorations, Vol 3, Iss 7, p e0467 (2021) |