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Analytic Review: The Pathogenetic and Prognostic Value of Biologic Markers in Acute Lung Injury

Division of Pulmonary/Critical Care, Stanford University, Stanford California, jlevitt@stanford. edu

Michael K. Gould, MD, MS, FCCP

Division of Pulmonary/Critical Care, VA Palo Alto Health Care System, Palo Alto, California

Loraine B. Ware, MD

Division of Allergy/Pulmonary & Critical Care, Vanderbilt University, Nashville, Tennessee

Michael A. Matthay, MD

Cardiovascular Research Institute, University of California, San Francisco, California

Over the past 2 decades, measurement of biomarkers in both the airspaces and plasma early in the course of acute lung injury has provided new insights into the mechanisms of lung injury. In addition, biologic markers of cell-specific injury, acute inflammation, and altered coagulation correlate with mortality from acute lung injury in several single center studies as well as in multicenter clinical trials. To date, biomarkers have been measured largely for research purposes. However, with improved understanding of their role in the pathogenesis of acute lung injury, biomarkers may play an important role in early detection of lung injury, risk stratification for clinical trials, and, ultimately, tailoring specific therapies to individual patients. This article provides a review of biologic markers in acute lung injury, with an emphasis on recent analysis of results from multicenter clinical trials.

Key Words: biomarkers • acute lung injury • acute respiratory distress syndrome • diagnosis • prognosis • pathogenesis • lung

This version was published on May 1, 2009

Journal of Intensive Care Medicine, Vol. 24, No. 3, 151-167 (2009)
DOI: 10.1177/0885066609332603


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