Predicting Acute Respiratory Distress Syndrome in Severe Blunt Trauma: The Utility of Interleukin-18.

摘要: Background: In trauma, direct pulmonary injury and innate immune response activation primes the lungs for acute respiratory distress syndrome (ARDS). The inflammasome-dependent release of interleukin-18 (IL-18) was recently identified as a key mediator in ARDS pathogenesis, leading us to hypothesize that plasma IL-18 is diagnostic predictor severe blunt trauma. Patients Methods: Secondary analysis Inflammation Host Response Injury database performed on cytokines collected within 12 hours Trauma-related cytokines, including IL-18, were compared between patients with without evaluated association using regression analysis. Threshold cytokine concentrations predictive determined receiver-operating curve (ROC) Results: Cytokine (n = 61) (n = 19) demonstrated elevated concentration remained correlated logistic after confounder adjustment (p = 0.008). Additionally, ROC revealed strong (area under [AUC] = 0.83), threshold value 170 pg/mL (Youden index, 0.3). Unlike ARDS, persisted during phase (p ≤ 0.02). Other trauma-related did not correlate ARDS. Conclusions: robust remains throughout phase. These findings support use biomarker, promoting early identification trauma at greater risk developing Timely recognition implementation advantageous supportive care practices may reduce morbidity costs.