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  • Title: The predictive value of Von Willebrand factor antigen plasma levels in children with acute lung injury.
    Author: El Basset Abo El Ezz AA, Abd El Hafez MA, El Amrousy DM, El Momen Suliman GA.
    Journal: Pediatr Pulmonol; 2017 Jan; 52(1):91-97. PubMed ID: 27362747.
    Abstract:
    OBJECTIVE: Von Willebrand factor antigen (VWF-Ag) is proved to be a marker for pulmonary endothelial injury in acute lung injury (ALI). We aimed to evaluate the predictive value of VWF-Ag plasma levels in children with ALI. METHODS: Prospective controlled study included 40 children with ALI as a patient group, 40 healthy children as a control group. Plasma VWF Ag level was measured at days 1 and 3 in patient group and measured once for control group. RESULTS: The commonest cause of ALI was pneumonia (35%). VWF Ag plasma levels were significantly higher in patient group than control group at days 1 and 3 (P = 0.001 and 0.002), respectively. Mean PaO2 /FiO2 of patients with ALI was 137 ± 65.38. Mortality was 30%. The deceased subgroup had significantly higher plasma levels of VWF Ag at days 1 and 3 than survived subgroup (P = 0.016 and P < 0.0001, respectively), significantly higher C reactive protein (P = 0.001), significantly higher rate of multisystem organ failure (MSOF) (P = 0.001), shorter duration of pediatric intensive care unit (PICU), and mechanical ventilation (MV) free days (P < 0.0001). Elevated VWF at day 1 was associated with significant MSOF (P = 0.011) and mortality (P = 0.009), while elevated VWF Ag at day 3 was associated with significant increase in MSOF (P = 0.004), length of MV (P = 0.024), and PICU stay (P = 0.011). VWF Ag has a high sensitivity (94.2%, 93.4%) and specificity (83.1%, 81.7%) for prediction of mortality at days 1 and 3, respectively. Multivariate regression analysis revealed that plasma VWF Ag level is an independent predictor of mortality in ARDS pediatric patients. CONCLUSION: Plasma VWF Ag level is an excellent predictive marker for outcome in children with ALI/ARDS. Pediatr Pulmonol. 2017;52:91-97. © 2016 Wiley Periodicals, Inc.
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