Effects of methylprednisolone infusion on markers of inflammation, coagulation, and angiogenesis in early acute respiratory distress syndrome
OBJECTIVE:Evaluate the effects of methylprednisolone on markers of inflammation, coagulation, and angiogenesis during early acute respiratory distress syndrome. DESIGN:Retrospective analysis. SETTING:Four intensive care units. SUBJECTS:Seventy-nine of 91 patients with available samples enrolled in a...
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| Veröffentlicht in: | Critical care medicine 2012-02, Vol.40 (2), p.495-501 |
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| creator | Seam, Nitin Meduri, G Umberto Wang, Honghui Nylen, Eric S Sun, Junfeng Schultz, Marcus J Tropea, Margaret Suffredini, Anthony F |
| description | OBJECTIVE:Evaluate the effects of methylprednisolone on markers of inflammation, coagulation, and angiogenesis during early acute respiratory distress syndrome.
DESIGN:Retrospective analysis.
SETTING:Four intensive care units.
SUBJECTS:Seventy-nine of 91 patients with available samples enrolled in a randomized, blinded controlled trial.
INTERVENTIONS:Early methylprednisolone infusion (n = 55) compared with placebo (n = 24).
MEASUREMENTS AND MAIN RESULTS:Interleukin-6, tumor necrosis factor α, vascular endothelial growth factor, protein C, procalcitonin, and proadrenomedullin were measured in archived plasma. Changes from baseline to day 3 and day 7 were compared between groups and in subgroups based on the precipitating cause of acute respiratory distress syndrome. Methylprednisolone therapy was associated with greater improvement in Lung Injury Score (p = .003), shorter duration of mechanical ventilation (p = .005), and lower intensive care unit mortality (p = .05) than control subjects. On days 3 and 7, methylprednisolone decreased interleukin-6 and increased protein C levels (all p < .0001) compared with control subjects. Proadrenomedullin levels were lower by day 3 with methylprednisolone treatment (p = .004). Methylprednisolone decreased interleukin-6 by days 3 and 7 in patients with pulmonary causes of acute respiratory distress syndrome but only at day 3 in those with extrapulmonary causes of acute respiratory distress syndrome. Protein C levels were increased with methylprednisolone on days 3 and 7 in patients with infectious and/or pulmonary causes of acute respiratory distress syndrome (all p < .0001) but not in patients with noninfectious or extrapulmonary causes of acute respiratory distress syndrome. Proadrenomedullin levels were decreased with methylprednisolone on day 3 in patients with infectious or extrapulmonary causes of acute respiratory distress syndrome (both p ≤ .008) but not in noninfectious or pulmonary acute respiratory distress syndrome. Tumor necrosis factor, vascular endothelial growth factor, and procalcitonin were elevated but not differentially affected by methylprednisolone therapy.
CONCLUSIONS:In early acute respiratory distress syndrome, administration of methylprednisolone was associated with improvement in important biomarkers of inflammation and coagulation and clinical outcomes. Biomarker changes varied with the precipitating cause of acute respiratory distress syndrome, suggesting that the underlying mechanisms and r |
| doi_str_mv | 10.1097/CCM.0b013e318232da5e |
| format | Article |
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DESIGN:Retrospective analysis.
SETTING:Four intensive care units.
SUBJECTS:Seventy-nine of 91 patients with available samples enrolled in a randomized, blinded controlled trial.
INTERVENTIONS:Early methylprednisolone infusion (n = 55) compared with placebo (n = 24).
MEASUREMENTS AND MAIN RESULTS:Interleukin-6, tumor necrosis factor α, vascular endothelial growth factor, protein C, procalcitonin, and proadrenomedullin were measured in archived plasma. Changes from baseline to day 3 and day 7 were compared between groups and in subgroups based on the precipitating cause of acute respiratory distress syndrome. Methylprednisolone therapy was associated with greater improvement in Lung Injury Score (p = .003), shorter duration of mechanical ventilation (p = .005), and lower intensive care unit mortality (p = .05) than control subjects. On days 3 and 7, methylprednisolone decreased interleukin-6 and increased protein C levels (all p < .0001) compared with control subjects. Proadrenomedullin levels were lower by day 3 with methylprednisolone treatment (p = .004). Methylprednisolone decreased interleukin-6 by days 3 and 7 in patients with pulmonary causes of acute respiratory distress syndrome but only at day 3 in those with extrapulmonary causes of acute respiratory distress syndrome. Protein C levels were increased with methylprednisolone on days 3 and 7 in patients with infectious and/or pulmonary causes of acute respiratory distress syndrome (all p < .0001) but not in patients with noninfectious or extrapulmonary causes of acute respiratory distress syndrome. Proadrenomedullin levels were decreased with methylprednisolone on day 3 in patients with infectious or extrapulmonary causes of acute respiratory distress syndrome (both p ≤ .008) but not in noninfectious or pulmonary acute respiratory distress syndrome. Tumor necrosis factor, vascular endothelial growth factor, and procalcitonin were elevated but not differentially affected by methylprednisolone therapy.
CONCLUSIONS:In early acute respiratory distress syndrome, administration of methylprednisolone was associated with improvement in important biomarkers of inflammation and coagulation and clinical outcomes. Biomarker changes varied with the precipitating cause of acute respiratory distress syndrome, suggesting that the underlying mechanisms and response to anti-inflammatory therapy may vary with the cause of acute respiratory distress syndrome.</description><identifier>ISSN: 0090-3493</identifier><identifier>ISSN: 1530-0293</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/CCM.0b013e318232da5e</identifier><identifier>PMID: 21983371</identifier><identifier>CODEN: CCMDC7</identifier><language>eng</language><publisher>Hagerstown, MD: by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood Coagulation - drug effects ; Blood Coagulation - physiology ; Critical Care - methods ; Dose-Response Relationship, Drug ; Double-Blind Method ; Drug Administration Schedule ; Early Diagnosis ; Emergency and intensive respiratory care ; Female ; Follow-Up Studies ; Hospital Mortality ; Humans ; Inflammation Mediators - analysis ; Inflammation Mediators - metabolism ; Infusions, Intravenous ; Intensive care medicine ; Interleukin-6 - metabolism ; Male ; Medical sciences ; Methylprednisolone - administration & dosage ; Middle Aged ; Neovascularization, Physiologic - drug effects ; Predictive Value of Tests ; Prospective Studies ; Reference Values ; Respiratory Distress Syndrome - diagnosis ; Respiratory Distress Syndrome - drug therapy ; Respiratory Distress Syndrome - metabolism ; Respiratory Distress Syndrome - mortality ; Risk Assessment ; Severity of Illness Index ; Statistics, Nonparametric ; Survival Rate ; Time Factors ; Treatment Outcome</subject><ispartof>Critical care medicine, 2012-02, Vol.40 (2), p.495-501</ispartof><rights>2012 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3819-3da582690b8c271f6689150835fd7bc15bdef56c95bf58723e46363494d3be343</citedby><cites>FETCH-LOGICAL-c3819-3da582690b8c271f6689150835fd7bc15bdef56c95bf58723e46363494d3be343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25498687$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21983371$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Seam, Nitin</creatorcontrib><creatorcontrib>Meduri, G Umberto</creatorcontrib><creatorcontrib>Wang, Honghui</creatorcontrib><creatorcontrib>Nylen, Eric S</creatorcontrib><creatorcontrib>Sun, Junfeng</creatorcontrib><creatorcontrib>Schultz, Marcus J</creatorcontrib><creatorcontrib>Tropea, Margaret</creatorcontrib><creatorcontrib>Suffredini, Anthony F</creatorcontrib><title>Effects of methylprednisolone infusion on markers of inflammation, coagulation, and angiogenesis in early acute respiratory distress syndrome</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVE:Evaluate the effects of methylprednisolone on markers of inflammation, coagulation, and angiogenesis during early acute respiratory distress syndrome.
DESIGN:Retrospective analysis.
SETTING:Four intensive care units.
SUBJECTS:Seventy-nine of 91 patients with available samples enrolled in a randomized, blinded controlled trial.
INTERVENTIONS:Early methylprednisolone infusion (n = 55) compared with placebo (n = 24).
MEASUREMENTS AND MAIN RESULTS:Interleukin-6, tumor necrosis factor α, vascular endothelial growth factor, protein C, procalcitonin, and proadrenomedullin were measured in archived plasma. Changes from baseline to day 3 and day 7 were compared between groups and in subgroups based on the precipitating cause of acute respiratory distress syndrome. Methylprednisolone therapy was associated with greater improvement in Lung Injury Score (p = .003), shorter duration of mechanical ventilation (p = .005), and lower intensive care unit mortality (p = .05) than control subjects. On days 3 and 7, methylprednisolone decreased interleukin-6 and increased protein C levels (all p < .0001) compared with control subjects. Proadrenomedullin levels were lower by day 3 with methylprednisolone treatment (p = .004). Methylprednisolone decreased interleukin-6 by days 3 and 7 in patients with pulmonary causes of acute respiratory distress syndrome but only at day 3 in those with extrapulmonary causes of acute respiratory distress syndrome. Protein C levels were increased with methylprednisolone on days 3 and 7 in patients with infectious and/or pulmonary causes of acute respiratory distress syndrome (all p < .0001) but not in patients with noninfectious or extrapulmonary causes of acute respiratory distress syndrome. Proadrenomedullin levels were decreased with methylprednisolone on day 3 in patients with infectious or extrapulmonary causes of acute respiratory distress syndrome (both p ≤ .008) but not in noninfectious or pulmonary acute respiratory distress syndrome. Tumor necrosis factor, vascular endothelial growth factor, and procalcitonin were elevated but not differentially affected by methylprednisolone therapy.
CONCLUSIONS:In early acute respiratory distress syndrome, administration of methylprednisolone was associated with improvement in important biomarkers of inflammation and coagulation and clinical outcomes. Biomarker changes varied with the precipitating cause of acute respiratory distress syndrome, suggesting that the underlying mechanisms and response to anti-inflammatory therapy may vary with the cause of acute respiratory distress syndrome.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood Coagulation - drug effects</subject><subject>Blood Coagulation - physiology</subject><subject>Critical Care - methods</subject><subject>Dose-Response Relationship, Drug</subject><subject>Double-Blind Method</subject><subject>Drug Administration Schedule</subject><subject>Early Diagnosis</subject><subject>Emergency and intensive respiratory care</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Inflammation Mediators - analysis</subject><subject>Inflammation Mediators - metabolism</subject><subject>Infusions, Intravenous</subject><subject>Intensive care medicine</subject><subject>Interleukin-6 - metabolism</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methylprednisolone - administration & dosage</subject><subject>Middle Aged</subject><subject>Neovascularization, Physiologic - drug effects</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Reference Values</subject><subject>Respiratory Distress Syndrome - diagnosis</subject><subject>Respiratory Distress Syndrome - drug therapy</subject><subject>Respiratory Distress Syndrome - metabolism</subject><subject>Respiratory Distress Syndrome - mortality</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Statistics, Nonparametric</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0090-3493</issn><issn>1530-0293</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc9u1DAQxi0EosvCGyDkC-JCiu2JE_uIVuWP1KqXco4cZ7xr6sSLnajKQ_SdMXShUi2PRmP_xiN_HyFvOTvnTLefdrurc9YzDghcCRCDkfiMbLgEVjGh4TnZMKZZBbWGM_Iq55-M8Vq28JKcCa4VQMs35P7CObRzptHREefDGo4Jh8nnGOKE1E9uyT5OtOzRpFtMf8lyHMw4mrlcfaQ2mv0SToWZhhJ7H_c4Yfa5sBRNCis1dpmRJsxHn8wc00oHn-dSZ5rXaUhxxNfkhTMh45tT3pIfXy5udt-qy-uv33efLysLiusKyl-VaDTrlRUtd02jNJdMgXRD21su-wGdbKyWvZOqFYB1A00Roh6gR6hhSz48vHtM8deCee5Gny2GYCaMS-60EK3Uosi6JfUDaVPMOaHrjskXJdaOs-6PD13xoXvqQ2l7dxqw9CMO_5v-CV-A9yfAZGuCS2ayPj9ystaqUe3j_LsY5qL-bVjuMHUHNGE-dKwsEHVTCcYFE6WqSnANvwE15qR9</recordid><startdate>201202</startdate><enddate>201202</enddate><creator>Seam, Nitin</creator><creator>Meduri, G Umberto</creator><creator>Wang, Honghui</creator><creator>Nylen, Eric S</creator><creator>Sun, Junfeng</creator><creator>Schultz, Marcus J</creator><creator>Tropea, Margaret</creator><creator>Suffredini, Anthony F</creator><general>by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201202</creationdate><title>Effects of methylprednisolone infusion on markers of inflammation, coagulation, and angiogenesis in early acute respiratory distress syndrome</title><author>Seam, Nitin ; Meduri, G Umberto ; Wang, Honghui ; Nylen, Eric S ; Sun, Junfeng ; Schultz, Marcus J ; Tropea, Margaret ; Suffredini, Anthony F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3819-3da582690b8c271f6689150835fd7bc15bdef56c95bf58723e46363494d3be343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood Coagulation - drug effects</topic><topic>Blood Coagulation - physiology</topic><topic>Critical Care - methods</topic><topic>Dose-Response Relationship, Drug</topic><topic>Double-Blind Method</topic><topic>Drug Administration Schedule</topic><topic>Early Diagnosis</topic><topic>Emergency and intensive respiratory care</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Inflammation Mediators - analysis</topic><topic>Inflammation Mediators - metabolism</topic><topic>Infusions, Intravenous</topic><topic>Intensive care medicine</topic><topic>Interleukin-6 - metabolism</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methylprednisolone - administration & dosage</topic><topic>Middle Aged</topic><topic>Neovascularization, Physiologic - drug effects</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Reference Values</topic><topic>Respiratory Distress Syndrome - diagnosis</topic><topic>Respiratory Distress Syndrome - drug therapy</topic><topic>Respiratory Distress Syndrome - metabolism</topic><topic>Respiratory Distress Syndrome - mortality</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Statistics, Nonparametric</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seam, Nitin</creatorcontrib><creatorcontrib>Meduri, G Umberto</creatorcontrib><creatorcontrib>Wang, Honghui</creatorcontrib><creatorcontrib>Nylen, Eric S</creatorcontrib><creatorcontrib>Sun, Junfeng</creatorcontrib><creatorcontrib>Schultz, Marcus J</creatorcontrib><creatorcontrib>Tropea, Margaret</creatorcontrib><creatorcontrib>Suffredini, Anthony F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seam, Nitin</au><au>Meduri, G Umberto</au><au>Wang, Honghui</au><au>Nylen, Eric S</au><au>Sun, Junfeng</au><au>Schultz, Marcus J</au><au>Tropea, Margaret</au><au>Suffredini, Anthony F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of methylprednisolone infusion on markers of inflammation, coagulation, and angiogenesis in early acute respiratory distress syndrome</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>2012-02</date><risdate>2012</risdate><volume>40</volume><issue>2</issue><spage>495</spage><epage>501</epage><pages>495-501</pages><issn>0090-3493</issn><issn>1530-0293</issn><eissn>1530-0293</eissn><coden>CCMDC7</coden><abstract>OBJECTIVE:Evaluate the effects of methylprednisolone on markers of inflammation, coagulation, and angiogenesis during early acute respiratory distress syndrome.
DESIGN:Retrospective analysis.
SETTING:Four intensive care units.
SUBJECTS:Seventy-nine of 91 patients with available samples enrolled in a randomized, blinded controlled trial.
INTERVENTIONS:Early methylprednisolone infusion (n = 55) compared with placebo (n = 24).
MEASUREMENTS AND MAIN RESULTS:Interleukin-6, tumor necrosis factor α, vascular endothelial growth factor, protein C, procalcitonin, and proadrenomedullin were measured in archived plasma. Changes from baseline to day 3 and day 7 were compared between groups and in subgroups based on the precipitating cause of acute respiratory distress syndrome. Methylprednisolone therapy was associated with greater improvement in Lung Injury Score (p = .003), shorter duration of mechanical ventilation (p = .005), and lower intensive care unit mortality (p = .05) than control subjects. On days 3 and 7, methylprednisolone decreased interleukin-6 and increased protein C levels (all p < .0001) compared with control subjects. Proadrenomedullin levels were lower by day 3 with methylprednisolone treatment (p = .004). Methylprednisolone decreased interleukin-6 by days 3 and 7 in patients with pulmonary causes of acute respiratory distress syndrome but only at day 3 in those with extrapulmonary causes of acute respiratory distress syndrome. Protein C levels were increased with methylprednisolone on days 3 and 7 in patients with infectious and/or pulmonary causes of acute respiratory distress syndrome (all p < .0001) but not in patients with noninfectious or extrapulmonary causes of acute respiratory distress syndrome. Proadrenomedullin levels were decreased with methylprednisolone on day 3 in patients with infectious or extrapulmonary causes of acute respiratory distress syndrome (both p ≤ .008) but not in noninfectious or pulmonary acute respiratory distress syndrome. Tumor necrosis factor, vascular endothelial growth factor, and procalcitonin were elevated but not differentially affected by methylprednisolone therapy.
CONCLUSIONS:In early acute respiratory distress syndrome, administration of methylprednisolone was associated with improvement in important biomarkers of inflammation and coagulation and clinical outcomes. Biomarker changes varied with the precipitating cause of acute respiratory distress syndrome, suggesting that the underlying mechanisms and response to anti-inflammatory therapy may vary with the cause of acute respiratory distress syndrome.</abstract><cop>Hagerstown, MD</cop><pub>by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</pub><pmid>21983371</pmid><doi>10.1097/CCM.0b013e318232da5e</doi><tpages>7</tpages></addata></record> |
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| ispartof | Critical care medicine, 2012-02, Vol.40 (2), p.495-501 |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood Coagulation - drug effects Blood Coagulation - physiology Critical Care - methods Dose-Response Relationship, Drug Double-Blind Method Drug Administration Schedule Early Diagnosis Emergency and intensive respiratory care Female Follow-Up Studies Hospital Mortality Humans Inflammation Mediators - analysis Inflammation Mediators - metabolism Infusions, Intravenous Intensive care medicine Interleukin-6 - metabolism Male Medical sciences Methylprednisolone - administration & dosage Middle Aged Neovascularization, Physiologic - drug effects Predictive Value of Tests Prospective Studies Reference Values Respiratory Distress Syndrome - diagnosis Respiratory Distress Syndrome - drug therapy Respiratory Distress Syndrome - metabolism Respiratory Distress Syndrome - mortality Risk Assessment Severity of Illness Index Statistics, Nonparametric Survival Rate Time Factors Treatment Outcome |
| title | Effects of methylprednisolone infusion on markers of inflammation, coagulation, and angiogenesis in early acute respiratory distress syndrome |
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