Evidence mapPaperPMID 35953795Full record

ArticleBMC pulmonary medicine2022

Elevated plasma levels of Krebs von den Lungen-6 and geographic appearance on high-resolution computed tomography are associated with diffuse alveolar damage in autopsy cases of acute respiratory distress syndrome: a retrospective study.

Ryosuke Imai, Daisuke Yamada, Yutaka Tomishima, Tomoaki Nakamura, Clara So, Shosei Ro, Kohei Okafuji, Atsushi Kitamura, Torahiko Jinta, Naoki Nishimura

Open access · goldAbstract read
In one paragraph

Article in BMC pulmonary medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Ryosuke ImaiDepartment of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan. imai.rysk@gmail.com.
Daisuke YamadaDepartment of Radiology, St. Luke's International Hospital, Tokyo, Japan.
Yutaka TomishimaDepartment of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan.
Tomoaki NakamuraDepartment of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan.
Clara SoDepartment of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan.
Shosei RoDepartment of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan.
Kohei OkafujiDepartment of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan.
Atsushi KitamuraDepartment of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan.
Torahiko JintaDepartment of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan.
Naoki NishimuraDepartment of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo, 104-8560, Japan.
St. Luke's International Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough diffuse alveolar damage (DAD) is a histopathological hallmark of acute respiratory distress syndrome (ARDS), its detection without lung biopsy is challenging. In patients with ARDS, the specificity of the Berlin definition to diagnose DAD as a reference standard is not adequately high, making it difficult to adequately diagnose DAD. The purpose of this study was to investigate the relationship between DAD and clinical findings, including KL-6 and geographic appearance, in ARDS patients and to identify more specific diagnostic criteria for DAD.

methodsAmong all adult autopsy cases at a tertiary hospital in Japan between January 2006 and March 2021, patients with ARDS who met the Berlin definition criteria were included. The patients' conditions were classified according to histopathological patterns as DAD or non-DAD, and clinical characteristics, laboratory data, and high-resolution computed tomography (HRCT) findings were compared between the two groups.

resultsDuring the study period, 27 met the Berlin definition (median age: 79 years, 19 men), of whom 18 (67%) had DAD and 9 (33%) did not. In the non-DAD group, histopathologic findings revealed organizing pneumonia in seven patients and pulmonary hemorrhage in two patients. On HRCT at onset, patients with DAD had more geographic appearance than those without DAD (89% vs. 44%). In patients with geographic appearance and elevated KL-6 (> 500 U/mL), the sensitivity and specificity for DAD diagnosis were 56% and 100%, respectively. All three patients with no geographic appearance and normal KL-6 did not have DAD.

conclusionsGeographic appearance on HRCT combined with KL-6 levels may predict the presence of DAD in patients with ARDS.

Indexed as

Pulmonary AlveoliRespiratory Distress SyndromeAdultAgedAutopsyHumansMaleRetrospective StudiesTomography, X-Ray ComputedAcute respiratory distress syndromeChest high-resolution computed tomographyDiffuse alveolar damageGeographic appearanceKL-6

Identifiers

PMID35953795
PMCPMC9367020
OpenAlexW4290996879

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.