Cytokine Panels and Pediatric Acute Respiratory Distress Syndrome: A Translational Investigation*

Objectives: To identify and compare serum and lower respiratory tract fluid biomarkers of lung injury using well-characterized mouse models of lung injury. To explore the relationship between these preclinical biomarkers and clinical outcomes in a discovery cohort of pediatric patients with acute respiratory failure from pneumonia. Design: Prospective, observational cohort study. Setting: A basic science laboratory and the PICU of a tertiary-care children’s hospital. Patients: PICU patients intubated for respiratory failure from a suspected respiratory infection. Interventions: Prospective enrollment and collection of lower respiratory tract fluid samples. Measurements and Main Results: C57BL6/J mice were intranasally inoculated with escalating doses of influenza A virus or toll-like receptor agonists to simulate varying degrees of lung injury. Serum and bronchoalveolar lavage fluid were measured for the presence of cytokines using commercially available multiplex cytokine assays. Elevated levels of C-C motif chemokine ligand 7 at the peak of inflammation in both bronchoalveolar lavage fluid and serum correlated with lethality, with the bronchoalveolar lavage fluid ratio of C-C motif chemokine ligand 7:C-C motif chemokine ligand 22 providing the best prediction in the mouse models. These preclinical biomarkers were examined in the plasma and lower respiratory tract fluid of a discovery cohort of pediatric patients with acute respirator...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Clinical Investigations Source Type: research