Influence of serum epidermal growth factor on mechanical ventilation and survival in patients with acute respiratory distress syndrome
Background: The mortality rate of acute respiratory distress syndrome has remained high. Studies have shown that concentrations of some of the inflammatory mediators, as well as some of the growth factors in serum and/or bronchoalveolar lavage, are higher in nonsurvivors. Objectives: We hypothesized in a previous study that it is possible that the serum level of epidermal growth factor (EGF) in nonsurvived patients would be higher than that of survived patients. Patients & methods: Data was evaluated for 30 patients diagnosed with acute respiratory distress syndrome on mechanical ventilation. Blood samples were taken before initiating mechanical ventilation as well as 2, 4 and 8 h after. Results: Serum EGF concentration was reduced (p < 0.05) in survivors 2 h after initiating mechanical ventilation. In addition, the differences between PaO2/FiO2 and Acute Physiology and Chronic Health Evaluation II score at the start and the end of the study was significant (p < 0.05). The serum EGF concentration increased after 8 h in nonsurvivors (p < 0.05). Significant changes in serum EGF concentrations in nonsurvivors at different time periods in the low positive end expiratory pressure group of patients (p < 0.05) were observed. Conclusion: Serum levels of EGF on admission may provide valuable information for predicting the outcome of acute respiratory distress syndrome patients. © 2005 Future Drugs Ltd.