ArticleJournal of medical biochemistry2026
Prognostic value of surfactant protein D and biochemical markers in BALF and plasma of ARDS patients undergoing mechanical ventilation.
Article in Journal of medical biochemistry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Surfactant protein D (SP-D) and circulating exosomes have emerged as potential biochemical indicators of lung injury severity in acute respiratory distress syndrome (ARDS). This study aimed to evaluate the prognostic value of SP-D levels and selected biochemical parameters in bronchoalveolar lavage fluid (BALF) and plasma among ARDS patients receiving mechanical ventilation. Methods: A total of 103 mechanically ventilated ARDS patients were enrolled between February 2020 and February 2023. Patients were classified into survival (n = 59) and death (n=44) groups based on 28-day mortality. On the day of diagnosis, SP-D and exosome levels in BALF and plasma, along with pH, lactate, and oxygenation-related indices, were measured and analyzed for prognostic relevance. Results: SP-D levels in both BALF and plasma were significantly higher in non-survivors (P < 0.001), while exosome levels did not differ significantly. The death group also showed elevated lactate and lower pH levels (P< 0.05). ROC analysis demonstrated high predictive value for SP-D in BALF (AuC=0.804) and plasma (AU C= 0.864), as well as for lactate and oxygenation indices. A combined biomarker model yielded an AUC of 0.883 for predicting 28-day mortality. Conclusions: SP-D concentrations in BALF and plasma, along with lactate and acid-base markers, serve as valuable biochemical predictors of short-term prognosis in ARDS patients undergoing mechanical ventilation.
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