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Critical Care: Critical Care: ARDS/ALI |

Elevated Plasma IL-35 Predicted Poor Outcome of Sepsis-Related ARDS Patients FREE TO VIEW

Yan Zhao; Jing He; Xinyu Deng; Wang Deng; Changyi Li; Daoxin Wang
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The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A152. doi:10.1016/j.chest.2016.02.158
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SESSION TITLE: Critical Care: ARDS/ALI

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Immunosuppressive leads to high mortality of sepsis. We speculated that IL-35 as a new immunoregulation mediator involved in sepsis-related ARDS. To test this hypothesis we determined the plasma level of IL-35 in critical ill patients and septic ARDS patients.

METHODS: In the early screening process, we found that IL - 35 increased in patients admitted to RICU, especially in subgroup characteristic as sepsis with ARDS. A total of 57 septic ARDS patients and another 10 healthy subjects enrolled in verified cohort. Biomarkers were measured and the APACHE II and SAPS II score were calculated based on the worst data of D1 once the patients met the defining criteria. Cox proportional hazards regression used to find possible risk factor. ROC curves and Kaplan-Meier survival curves used to test the predict effectiveness of IL-35. We also followed up the dynamic changes of the IL - 35 during first 7 days.

RESULTS: The level of IL-35 increased significantly in sepsis-related ARDS patients, especially in severe subgroup and nonsurvivors. Elevated plasma IL-35 level on D1 was an independent indicator for predicting mortality with a hazard ratio of 1.189 (1.096-1.290). According to ROC curve, the AUROC of IL-35 is 0.855 (p <0.0001) and optimal cut-off point was 47.37pg/ml to predict mortality. In predicting MODS morbidity, the AUROC of IL-35 is 0.683 (p=0.0361) and optimal cut-off point was 46.98pg/ml. In addition, we also found that IL-35 positively correlated with APACHE II score and negatively correlated with the P/F ratio. During fist 7 days, nonsurvivors presented decreased trends of IL-35 based on higher background.

CONCLUSIONS: Elevated plasma IL-35 level on D1 was a credible biomarker to predict mortality and MODS morbidity in septic ARDS patients.

CLINICAL IMPLICATIONS: Immunosuppressive may correlate with development of sepsis-related ARDS.

DISCLOSURE: The following authors have nothing to disclose: Yan Zhao, Jing He, Xinyu Deng, Wang Deng, Changyi Li, Daoxin Wang

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