A therapeutic strategy based on alkalinization with sodium bicarbonate along with hyperventilation and calcium administration increases pH and improves cardiovascular function.
The current study looked at the levels of MMP-8 and TIMP-1 in blood samples from a large cohort of patients with ARF. The investigators tried to show whether increases in either the levels of these proteins or their ratio are associated with increased mortality. Of 563 patients, only 43 had ARDS, and therefore, the information collected from the study did not reach statistical significance concerning patients with ARDS specifically. However, the investigators found that higher blood levels of TIMP-1 immediately after admission were associated with higher mortality. Moreover, this was an independent risk factor for mortality after including other recognized risk factors, such as SAPS II and SOFA score, in the model.The investigators concluded that further studies are required in order to fully understand the predictive value of these markers. It would be interesting to assess their levels in local samples (tracheal aspirates, for example) and compare those to blood levels. However, as with all other biomarkers, the large SD in the levels as well as the rapidly changing time course place the clinical usefulness of such tests in question.
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