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Mediators of Inflammation
Volume 2018, Article ID 1739615, 10 pages
https://doi.org/10.1155/2018/1739615
Research Article

Predictive Value of Combined LIPS and ANG-2 Level in Critically Ill Patients with ARDS Risk Factors

1Institute of Respiratory Disease, Department of Respiratory, Respiratory Intensive Care Unit, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
2Emergency Department, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
3Gastroenterology Department, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
4Department of Neurosurgery, Neurosurgical Intensive Care Unit, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
5Intensive Care Unit, Daping Hospital, Third Military Medical University, Chongqing 400042, China
6Department of Respiratory, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
7Department of Respiratory, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400011, China

Correspondence should be addressed to Chun-Xia Mei; moc.361@xcm1111 and Guan-Song Wang; moc.361@3002sggnaw

Received 29 November 2017; Revised 12 April 2018; Accepted 16 April 2018; Published 12 June 2018

Academic Editor: Giuseppe Valacchi

Copyright © 2018 Zhi Xu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

To investigate the predictive value of the acute physiology and chronic health evaluation 2 (APACHE2) score and lung injury prediction score (LIPS) for acute respiratory distress syndrome (ARDS) when combined with biomarkers for this condition in patients with ARDS risk factors. In total, 158 Han Chinese patients with ARDS risk factors were recruited from the Respiratory and Emergency Intensive Care Units. The LIPS, APACHE2 score, primary diagnosis at admission, and ARDS risk factors were determined within 6 h of admission, and PaO2/FiO2 was determined on the day of admission. Blood was collected within 24 h of admission for the measurement of angiopoietin-2 (ANG-2), sE-selectin, interleukin-6 (IL-6), and interleukin-8 (IL-8) levels. ARDS was monitored for the next 7 days. Univariate and multivariate analyses and receiver operating characteristic (ROC) analyses were employed to construct a model for ARDS prediction. Forty-eight patients developed ARDS within 7 days of admission. Plasma ANG-2 level, sE-selectin level, LIPS, and APACHE2 score in ARDS patients were significantly higher than those in non-ARDS patients. ANG-2 level, LIPS, and APACHE2 score were correlated with ARDS (, , and , resp.). When the APACHE2 score was used in combination with the LIPS and ANG-2 level to predict ARDS, the area under the ROC curve (AUC) was not significantly increased. Compared to LIPS or ANG-2 alone, LIPS in combination with ANG-2 had significantly increased positive predictive value (PPV) and AUC for the prediction of ARDS. In conclusion, plasma ANG-2 level, LIPS, and APACHE2 score are correlated with ARDS. Combined LIPS and ANG-2 level displays favorable sensitivity, specificity, and AUC for the prediction of ARDS.