Activation of coagulation and fibrinolysis in acute respiratory distress syndrome : A prospective pilot study

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dc.contributor.authorOzolina, Agnese
dc.contributor.authorSarkele, Marina
dc.contributor.authorSabelnikovs, Olegs
dc.contributor.authorSkesters, Andrejs
dc.contributor.authorJaunalksne, Inta
dc.contributor.authorSerova, Jelena
dc.contributor.authorIevins, Talis
dc.contributor.authorBjertnaes, Lars J.
dc.contributor.authorVanags, Indulis
dc.contributor.institutionRīga Stradiņš University
dc.contributor.institutionBioķīmijas zinātniskā laboratorija
dc.date.accessioned2021-06-16T08:45:01Z
dc.date.available2021-06-16T08:45:01Z
dc.date.issued2016
dc.descriptionFunding Information: The study was supported by grant ZP 10/2013 from Rigas Stradins University. Publisher Copyright: © 2016 Ozolina, Sarkele, Sabelnikovs, Skesters, Jaunalksne, Serova, Ievins, Bjertnaes and Vanags.
dc.description.abstractIntroduction: Coagulation and fibrinolysis remain sparsely addressed with regards to acute respiratory distress syndrome (ARDS). We hypothesized that ARDS development might be associated with changes in plasma coagulation and fibrinolysis. Our aim was to investigate the relationships between ARDS diagnosis and plasma concentrations of tissue factor (TF), tissue plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) in mechanically ventilated patients at increased risk of developing ARDS. Materials and methods: We performed an ethically approved prospective observational pilot study. Inclusion criteria were patients with PaO 2 /FiO 2 < 300 mmHg admitted to the intensive care unit (ICU) for mechanical ventilation for 24 h, or more, because of one or more disease conditions associated with increased risk of developing ARDS. Exclusion criteria were age below 18 years; cardiac disease. We sampled plasma prospectively and compared patients who developed ARDS with those who did not using descriptive statistics and chi-square analysis of baseline demographical and clinical data. We also analyzed plasma concentrations of TF, t-PA, and PAI-1 at inclusion (tissue) and on third (T 3 ) and seventh day (T 7 ) of the ICU stay with non-parametric statistics inclusive their sensitivity and specificity associated with the development of ARDS using receiver operating characteristic curve analysis. Statistical significance: p < 0.05. Results: Of 24 patients at risk, 6 developed mild ARDS and 4 of each moderate or severe ARDS, respectively, 3 ± 2 (mean ± SD) days after inclusion. Median plasma concentrations of TF and PAI-1 were significantly higher at T7 in patients with ARDS, as compared to non-ARDS. Simultaneously, we found moderate correlations between plasma concentrations of TF and PAI-1, TF and PaO 2 /FiO 2 , and positive end-expiratory pressure and TF. TF plasma concentration was associated with ARDS with 71% sensitivity and 100% specificity, a cut off level of 145 pg/ml and AUC 0.78, p = 0.02. PAI-1 displayed 64% sensitivity and 100% specificity with a cut off concentration of 117.5 pg/ml and AUC 0.77, p = 0.02. t-PA did not change significantly during the observation time. Conclusion: This pilot study showed that increased plasma concentrations of TF and PAI-1 might support ARDS diagnoses in mechanically ventilated patients after 7 days in ICU.en
dc.description.statusPeer reviewed
dc.format.extent10
dc.format.extent1081472
dc.identifier.citationOzolina, A, Sarkele, M, Sabelnikovs, O, Skesters, A, Jaunalksne, I, Serova, J, Ievins, T, Bjertnaes, L J & Vanags, I 2016, 'Activation of coagulation and fibrinolysis in acute respiratory distress syndrome : A prospective pilot study', Frontiers in Medicine, vol. 3, no. NOV, 64. https://doi.org/10.3389/fmed.2016.00064
dc.identifier.doi10.3389/fmed.2016.00064
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/5102
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85029538900&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofFrontiers in Medicine
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectAcute respiratory distress syndrome
dc.subjectLung injury
dc.subjectPlasminogen activator inhibitor-1
dc.subjectTissue factor
dc.subjectTissue plasminogen activator
dc.subjectVentilator-associated lung injury
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectGeneral Medicine
dc.titleActivation of coagulation and fibrinolysis in acute respiratory distress syndrome : A prospective pilot studyen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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