1. Elevated PAI-1 is associated with poor clinical outcomes in pediatric patients with acute lung injury
- Author
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Sapru, Anil, Curley, Martha A., Brady, Sandra, Matthay, Michael A., and Flori, Heidi
- Subjects
Medicine & Public Health ,Pediatrics ,Pain Medicine ,Pneumology/Respiratory System ,Emergency Medicine ,Anesthesiology ,Intensive / Critical Care Medicine ,Accurate respiratory distress syndrome ,Acute lung injury ,Clinical studies ,Pediatrics ,Plasminogen activator inhibitor-1 (PAI-1) - Abstract
Deposition of fibrin in the alveolar space is a hallmark of acute lung injury (ALI). Plasminogen activator inhibitor-1 (PAI-1) is an antifibrinolytic agent that is activated during inflammation. Increased plasma and pulmonary edema fluid levels of PAI-1 are associated with increased mortality in adults with ALI. This relationship has not been examined in children. The objective of this study was to test whether increased plasma PAI-1 levels are associated with worse clinical outcomes in pediatric patients with ALI.We measured plasma PAI-1 levels on the first day of ALI among 94 pediatric patients enrolled in two separate prospective, multicenter investigations and followed them for clinical outcomes. All patients met American European Consensus Conference criteria for ALI.A total of 94 patients were included. The median age was 3.2 years (range 16 days–18 years), the PaO2/FiO2 was 141 ± 72 (mean ± SD), and overall mortality was 14/94 (15%). PAI-1 levels were significantly higher in nonsurvivors compared to survivors (P
- Published
- 2010