Plasma sRAGE is independently associated with increased mortality in ARDS: a meta-analysis of individual patient data
Year: 2018
Type: review
Study design: Systematic Review
Abstract: The soluble receptor for advanced glycation end-products (sRAGE) is a marker of lung epithelial injury and alveolar fluid clearance (AFC), with promising values for assessing prognosis and lung injury severity in acute respiratory distress syndrome (ARDS). Because AFC is impaired in most patients with ARDS and is associated with higher mortality, we hypothesized that baseline plasma sRAGE would predict mortality, independently of two key mediators of ventilator-induced lung injury. We conducted a meta-analysis of individual data from 746 patients enrolled in eight prospective randomized and observational studies in which plasma sRAGE was measured in ARDS articles published through March 2016. The primary outcome was 90-day mortality. Using multivariate and mediation analyses, we tested the association between baseline plasma sRAGE and mortality, independently of driving pressure and tidal volume. Higher baseline plasma sRAGE [odds ratio (OR) for each one-log increment, 1.18; 95% confidence interval (CI) 1.01–1.38; P = 0.04], driving pressure (OR for each one-point increment, 1.04; 95% CI 1.02–1.07; P = 0.002), and tidal volume (OR for each one-log increment, 1.98; 95% CI 1.07–3.64; P = 0.03) were independently associated with higher 90-day mortality in multivariate analysis. Baseline plasma sRAGE mediated a small fraction of the effect of higher Δ P on mortality but not that of higher V T . Higher baseline plasma sRAGE was associated with higher 90-day mortality in patients with ARDS, independently of driving pressure and tidal volume, thus reinforcing the likely contribution of alveolar epithelial injury as an important prognostic factor in ARDS. Registration: PROSPERO (ID: CRD42018100241).
Source: Intensive Care Medicine
Authors: Matthieu Jabaudon, Raiko Blondonnet, Bruno Pereira, Rodrigo Cartin-Ceba, Christoph Lichtenstern, Tommaso Mauri, Rogier M. Determann, Tomas Drabek, Rolf D. Hubmayr, Ognjen Gajic, Florian Uhle, Andrea Coppadoro, Antonio Pesenti, Marcus J. Schultz, Marco V. Ranieri, Helena Brodska, Ségolène Mrozek, Vincent Sapin, Michael A. Matthay, Jean-Michel Constantin, Carolyn S. Calfee
Institutions: Centre National de la Recherche Scientifique, Inserm, Université Clermont Auvergne, Centre Hospitalier Universitaire de Clermont-Ferrand, Institut Génétique, Reproduction et Développement, Mayo Clinic, University Hospital Heidelberg, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, OLVG, University of Pittsburgh, Azienda Ospedaliera San Gerardo, Amsterdam UMC Location University of Amsterdam, Mahidol Oxford Tropical Medicine Research Unit, University of Amsterdam, University of Turin, Charles University, General University Hospital in Prague, Université Toulouse III - Paul Sabatier, Centre Hospitalier Universitaire de Toulouse, Université de Toulouse, University of California, San Francisco
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,190
Awards: Translational Approach to Understanding RAGE pathway in Acute respiratory distress syndrome : physiopathologic, diagnostic and therapeutic implications, G13806056, ARDS Endotypes: Expanded Analysis of Clinical and Biological Phenotypes and Evolution Over Time, G3429402575, RESOLUTION OF CLINICAL LUNG INJURY, G6084844149, Precision Medicine in the Acute Respiratory Distress Syndrome, G8920118733, Resolution of Clinical Lung Injury
OpenAlex ID: W2883789215