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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, Talins
dc.contributor.authorBjertnæs, Lars J.
dc.contributor.authorVanags, Indulis
dc.date.accessioned2017-02-28T13:35:53Z
dc.date.available2017-02-28T13:35:53Z
dc.date.issued2016-11-28
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. <p> Materials and methods: We performed an ethically approved prospective observational pilot study. Inclusion criteria were patients with PaO2/FiO2 < 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 (T0) and on third (T3) and seventh day (T7) 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. <p>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 PaO2/FiO2, 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.en_US
dc.descriptionPublished version. Source at <a href=https://doi.org/10.3389/fmed.2016.00064> https://doi.org/10.3389/fmed.2016.00064 </a>en_US
dc.identifier.citationOzolina A. et.al.: (2016) Activation of Coagulation and Fibrinolysis in Acute Respiratory Distress Syndrome: A Prospective Pilot Study. Front. Med. 3:64. doi: 10.3389/fmed.2016.00064en_US
dc.identifier.cristinIDFRIDAID 1433750
dc.identifier.doi10.3389/fmed.2016.00064
dc.identifier.issn2296-858X
dc.identifier.urihttps://hdl.handle.net/10037/10389
dc.language.isoengen_US
dc.publisherFrontiers Mediaen_US
dc.relation.journalFrontiers in medicine
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750en_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750en_US
dc.titleActivation of Coagulation and Fibrinolysis in Acute Respiratory Distress Syndrome: A Prospective Pilot Studyen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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