PROGNOSTIC VALUE OF CLINICAL SCORES, PENTRAXIN3 AND C - REACTIVE PROTEIN IN TOXIN-RELATED ACUTE LUNG INJURY AND ACUTE RESPIRATORY DISTRESS SYNDROME

Document Type : Original Article

Authors

1 Poison Control Center- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2 Poison Control Center- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Objectives: Toxin-related ALI (Acute lung injury) and/or ARDS (Acute respiratory distress syndrome) is challenging to critical care physicians. This study aimed at evaluation of clinical scores, pentraxin-3 (PTX3) and C-reactive protein (CRP) as predictors of severity and outcome in toxin – related ALI/ARDS in 50 acutely intoxicated patients. Material and Method: Laboratory variables were assessed on day1, day 2, day3 and endpoint. Clinical data were employed in the calculation of APACHE II score, Lung Injury score (LIS), Sequential Organ Failure Assessment (SOFA) score. Results: Several variables were associated with poor outcome in the poisoned ARDS patients like prolonged ICU stay, prolonged duration of mechanical ventilation, low PO2/FiO2 and SO2/FiO2 ratios, high APACHE II, SOFA and lung injury scores on the 1st day, elevated plasma PTX3 levels on the 1st day, and elevated serum CRP levels after 24 hours of admission. APACHE II score surpassed other scores as an excellent predictor of outcome within the 1st 24 hours of admission. PTX3 represented an early marker of severity, and its levels correlated with parameters of lung injury, systemic organ failure and outcome. Conclusion: Early combination of plasma PTX3 and predictive scores could help in identifying patients at risk of severe fatal toxin – related ARDS

Keywords

The Egyptian Journal of Forensic Sciences and Applied Toxicology
Volume 17, Issue 2
Forensic Topics
December 2017
Pages 93-115

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