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Table 1 Systemic markers differentiating ALI/ARDS from CPE

From: A systematic review of diagnostic methods to differentiate acute lung injury/acute respiratory distress syndrome from cardiogenic pulmonary edema

Study

Design

No. of ALI/ARDS vs CPE

marker

Timing of measurement

Mean value ± SD/SEM or median (IQR or range) in ALI/ARDS

Mean value ± SD/SEM or median (IQR or range) in CPE

Unit

p value

AUC

SD or 95% CI

Cutoff

For

Specificity (%)

Sensitivity (%)

Markers of cardiomyocyte stress

Bajwa, 2013***

Retrospective

826 vs 87

ST-2

The day of enrollment

534 (IQR325.0–724.9)

43 (IQR26.4–78.6)

ng/mL

<0.0001

0.98

n.d. (p <0.0001)

142

ALI/ARDS

91

94

Komiya, 2011***

Prospective

53 vs 71

BNP

Within 2 h after arriving

202 (IQR95–439)

691 (IQR416–1194)

pg/mL

<0.001

0.831

0.759–0.904

500

CPE

83.1

69

   

CRP

at ER

119 (IQR62–165)

8 (IQR2–42)

mg/L

<0.001

0.887

0.826–0.948

50

ALI/ARDS

69.8

59.2

   

BNP + CRP

 

n.d.

n.d.

n.d.

n.d.

0.931

0.884–0.978

n.d.

n.d.

n.d.

n.d.

Levitt, 2008**

Prospective

33 vs 21

BNP

Within 48 h of ICU adm.

369 (IQR87–709)

600 (IQR352–1300)

pg/mL

0.04

0.67

0.52–0.81

100

ALI/ARDS

95.2

27.3

Karmpaliotis, 2007***

Prospective

51 vs 23

BNP

Not stated

325 (IQR82–767)

1260 (IQR541–2020)

pg/mL

0.0001

0.79

n.d.

200

ALI/ARDS

91

40

Rana, 2006***

Retrospective + Prospective

131 vs 73

BNP

Median 3 h after diagnosis

344 (IQR122–745)

759 (IQR378–1320)

pg/mL

<0.001

0.71

n.d.

250

ALI/ARDS

90

40

Other circulating markers

Lin Q, 2013***

Prospective

78 vs 28

Plasma HBP

At enrollment

17.15 (IQR11.95–24.07)

9.50 (IQR7.98–12.18)

ng/mL

<0.001

0.851

±0.040

11.55

ALI/ARDS

78.2

75

Lin Q, 2012***

Prospective

87 vs 34

Copeptin

At enrollment

52.53 (IQR29.81–91.43)

25.14 (IQR21.04–34.26)

pmol/L

<0.001

0.823

±0.038

40.11

ALI/ARDS

88.2

60.9

Arif, 2002*

Prospective

11 vs 12

Transferrin in plasma

Within 72 h of ICU adm.

1.0 (range 0.5–1.5)

2.1 (range 1.5–2.7)

g/L

<0.001

0.98

n.d.

1.5

ARDS

87

100

   

TP in plasma

 

49 (range 41–59)

63 (range 51–69)

g/L

<0.001

0.95

n.d.

59

ARDS

75

100

   

Alb in plasma

 

25 (range17–34)

30 (range 25–43)

g/L

NS

0.8

n.d.

24

ARDS

100

45

   

Pulmonary leak index

 

32.3 (range23.0–54.4)

10.1 (range 4.4–16.2)

X10^-3/m

<0.001

1

n.d.

16.3

ARDS

100

100

Shih, 1997*

Prospective

13 vs 5

MAA in serum

Not stated

53.8 ± 6.6 SEM

9.0 ± 3.1 SEM

ng/mL

<0.05

n.d.

n.d.

n.d.

n.d.

n.d.

n.d.

Backer, 1997*

Prospective

43 vs 9

AVLAC

Not stated

0.20 ± 0.230 SD

0.139 ± 0.176 SD

mEq/L

<0.001

n.d.

n.d.

n.d.

n.d.

n.d.

n.d.

  1. Alb albumin, ALI acute lung injury, ARDS acute respiratory distress syndrome, AUC area under the curve, AVLAC arteriovenous differences in lactate, BNP brain natriuretic peptide, CPE cardiogenic pulmonary edema, CRP C-reactive protein, ER emergency department, HBP heparin-binding protein, MAA mucin-associated antigen, n.d. not described, SP-A surfactant Protein-A, SP-B surfactant protein-B, SEM standard error of the mean, SD standard deviation, ST-2 suppression of tumorigencity-2, TP total protein
  2. ***good, **moderate, or *poor quality assessed based on the modified Hayden’s criteria
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