Prognostic Value of Clinical Scores, Pentraxin3 and C - Reactive Protein in Toxin-Related Acute Lung Injury and Acute Respiratory Distress Syndrome

Abstract

Objectives: Toxin-related ALI (Acute lung injury) and/or ARDS (Acute respiratory distress syndrome) is challenging to critical care physicians. This study aimed at evaluation of clinical scores, pentraxin-3 (PTX3) and C-reactive protein (CRP) as predictors of severity and outcome in toxinrelated ALI/ARDS in 50 acutely intoxicated patients. Material and Method: Laboratory variables were assessed on day1, day 2, day3 and endpoint. Clinical data were employed in the calculation of APACHE II score, Lung Injury score (LIS), Sequential Organ Failure Assessment (SOFA) score. Results: Several variables were associated with poor outcome in the poisoned ARDS patients like prolonged ICU stay, prolonged duration of mechanical ventilation, low PO2/FiO2 and SO2/FiO2 ratios, high APACHE II, SOFA and lung injury scores on the 1 st day, elevated plasma PTX3 levels on the 1 st day, and elevated serum CRP levels after 24 hours of admission. APACHE II score surpassed other scores as an excellent predictor of outcome within the 1 st 24 hours of admission. PTX3 represented an early marker of severity, and its levels correlated with parameters of lung injury, systemic organ failure and outcome. Conclusion: Early combination of plasma PTX3 and predictive scores could help in identifying patients at risk of severe fatal toxinrelated ARDS.