Outcome value of Clara cell protein in serum of patients with acute respiratory distress syndrome

• DOI: 10.1007/s00134-006-0235-1
• Publication Date: 2006-06-22T12:07:11Z
• Authors: Olivier Lesur; Stephan Langevin; Yves Berthiaume; Martin Légaré; Yoanna Skrobik; Jean-François Bel...; Bruno Lévy; Yvan Fortier; Francois Lauzier; Gina Bravo; Marc Nickmilder; Eric Rousseau; Alfred Bernard
• Keywords: Adult; Male; Respiratory Distress Syndrome; Middle Aged; Respiration, Artificial; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; Multivariate Analysis; Humans; Uteroglobin; Female; Prospective Studies; Aged

Injury to the alveolocapillary barrier characterizes ALI/ARDS; therefore determining levels of lung epithelium-specific small proteins in serum may help predict clinical outcomes. We examined whether serum Clara cell protein (CC-16) concentration is correlated with the outcome, mechanical ventilation duration, and incidence of nonpulmonary organ failure.Prospective multicenter observational study conducted by the Quebec Critical Care Network.Seventy-eight adult ARDS patients requiring mechanical ventilation were enrolled and 28-day mortality was the primary outcome. Ventilatory parameters were computed and blood was sampled daily. Clinical information collected included cause of death, duration of mechanical ventilation, number of ventilator-free days, and organ failures.Median serum levels of CC-16 were significantly higher in nonsurvivors than survivors on days 0-2 (19.93 microg/l, IQR 11.8-44.32, vs. 8.9, 5.66-26.38) and sustained up to day 14. CC-16 levels were correlated positively with the number of failing organs (rho 0.3623) and requirement for prolonged mechanical ventilation. Predictors of patient mortality included age, arterial carbon dioxide partial pressure, CC-16, and APACHE II score (odds ratios 1.35, 1.52, 1.37, 1.159, respectively).Higher initial CC-16 serum level is associated with increased risk of death, fewer ventilator-free days, and increased frequency of nonpulmonary multiple organ failure. CC-16 is a valuable biomarker of ARDS that may help predict outcome among ARDS patients with high-risk mortality.