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Int J Crit Illn Inj Sci . 2 Correlation between serum surfactant protein-D level with respiratory compliance and acute respiratory distress syndrome

tetano

Editor, Senior Moderator
Int J Crit Illn Inj Sci


. 2022 Oct-Dec;12(4):204-210.
doi: 10.4103/ijciis.ijciis_27_22. Epub 2022 Dec 26.
Correlation between serum surfactant protein-D level with respiratory compliance and acute respiratory distress syndrome in critically ill COVID-19 Patients: A retrospective observational study


Jayadi[SUP] 1 [/SUP], Prananda Surya Airlangga[SUP] 1 [/SUP], Edward Kusuma[SUP] 1 [/SUP], Christrijogo Soemartono Waloejo[SUP] 1 [/SUP], Agustina Salinding[SUP] 1 [/SUP], Pudji Lestari[SUP] 2 [/SUP]



Affiliations

Abstract

Background: Acute respiratory distress syndrome (ARDS) is one of the manifestations of severe coronavirus disease 2019 (COVID-19) with low respiratory compliance and poor oxygenation as main characteristics and mortality rate of 50%-94%. Surfactants, including surfactant protein D (SP-D), have a role in maintaining respiratory compliance. This study aimed to analyze the relationship between serum SP-D levels with respiratory compliance and ARDS in patients with critically ill COVID-19 pneumonia.
Methods: This study was a cross-sectional study. Subjects were adult reverse transcription-polymerase chain reaction-confirmed COVID-19 patients who had ARDS treated with invasive mechanical ventilation. All data were obtained from medical records. Statistical analysis was done using Spearman test, Mann-Whitney test, and receiver operating characteristic curve.
Results: Serum level of SP-D was significantly correlated with static respiratory compliance (P = 0.009; correlation coefficient [rs] = 0.467). Serum SP-D levels correlated with ARDS severity (P < 0.001). SP-D levels had a very strong diagnostic value for ARDS severity, with an optimal cutoff value of 44.24 ng/mL (sensitivity 92.3%; specificity 94.1%). ARDS severity also correlated significantly with respiratory compliance (P = 0.005; correlation coefficient 0.496).
Conclusion: Higher serum SP-D levels were associated with lower respiratory compliance, ARDS severity, and may be utilized diagnostically to identify patients with severe ARDS.

Keywords: Coronavirus disease 2019; critical care; lung compliance; pulmonary surfactant-associated protein d; respiratory distress syndrome.
 
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