{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:36:53Z","timestamp":1791203813275,"version":"4.2.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2008,3,21]],"date-time":"2008-03-21T00:00:00Z","timestamp":1206057600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2008,3,21]],"date-time":"2008-03-21T00:00:00Z","timestamp":1206057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Background<\/jats:title>\n                        <jats:p>Acute lung injury (ALI) is a major cause of acute respiratory failure with high mortality despite lung-protective ventilation. Prior work has shown disordered inflammation and coagulation in ALI, with strong correlations between biomarker abnormalities and worse clinical outcomes. We measured plasma markers of inflammation, coagulation and fibrinolysis simultaneously to assess whether these markers remain predictive in the era of lung-protective ventilation.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>Plasma samples and ventilator data were prospectively collected from 50 patients with early ALI. Plasma biomarkers of inflammation (IL-6, IL-8, intercellular adhesion molecule 1), of coagulation (thrombomodulin, protein C) and of fibrinolysis (plasminogen activator inhibitor 1) were measured by ELISA. Biomarker levels were compared between survivors (n = 29) and non-survivors (n = 21) using Mann\u2013Whitney analysis.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>The tidal volume for the study group was 6.6 \u00b1 1.1 ml\/kg predicted body weight and the plateau pressure was 25 \u00b1 7 cmH<jats:sub>2<\/jats:sub>O (mean \u00b1 standard deviation), consistent with lung-protective ventilation. All markers except IL-6 were significantly different between survivors and nonsurvivors. Nonsurvivors had more abnormal values. Three biomarkers \u2013 IL-8, intercellular adhesion molecule 1 and protein C \u2013 remained significantly different by multivariate analysis that included age, gender, Simplified Acute Physiology Score II and all biomarkers that were significant on bivariate analysis. Higher levels of IL-8 and intercellular adhesion molecule 1 were independently predictive of worse outcomes (odds ratio = 2.0 and 5.8, respectively; <jats:italic>P<\/jats:italic> = 0.04 for both). Lower levels of protein C were independently associated with an increased risk of death (odds ratio = 0.5), a result that nearly reached statistical significance (<jats:italic>P<\/jats:italic> = 0.06).<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusion<\/jats:title>\n                        <jats:p>Despite lung-protective ventilation, abnormalities in plasma levels of markers of inflammation, coagulation and fibrinolysis predict mortality in ALI patients, indicating more severe activation of these biologic pathways in nonsurvivors.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc6846","type":"journal-article","created":{"date-parts":[[2008,3,21]],"date-time":"2008-03-21T19:13:27Z","timestamp":1206126807000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":137,"title":["Biomarkers of inflammation, coagulation and fibrinolysis predict mortality in acute lung injury"],"prefix":"10.1186","volume":"12","author":[{"given":"Dana","family":"McClintock","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanjing","family":"Zhuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Wickersham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Matthay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine B","family":"Ware","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2008,3,21]]},"reference":[{"key":"6279_CR1","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.1056\/NEJMoa050333","volume":"353","author":"GD Rubenfeld","year":"2005","unstructured":"Rubenfeld GD, Caldwell E, Peabody E, Weaver J, Martin DP, Neff M, Stern EJ, Hudson LD: Incidence and outcomes of acute lung injury.\n                           N Engl J Med 2005, 353: 1685-1693. 10.1056\/NEJMoa050333","journal-title":"N Engl J Med"},{"key":"6279_CR2","doi-asserted-by":"publisher","first-page":"1782","DOI":"10.1097\/00003246-199611000-00004","volume":"24","author":"MD Moss","year":"1996","unstructured":"Moss MD, Gillespie MK, Ackerson L, Moore FA, Moore EE, Parsons PE: Endothelial cell activity varies in patients at risk for the adult respiratory distress syndrome.\n                           Crit Care Med 1996, 24: 1782-1786. 10.1097\/00003246-199611000-00004","journal-title":"Crit Care Med"},{"key":"6279_CR3","doi-asserted-by":"publisher","first-page":"83S","DOI":"10.1378\/chest.116.suppl_1.83S","volume":"116","author":"ER Conner","year":"1999","unstructured":"Conner ER, Ware LB, Modin G, Matthay MA: Elevated pulmonary edema fluid concentrations of soluble intercellular adhesion molecule-1. 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