Prognostic value of pulmonary ultrasound score combined with plasma miR‐21‐3p expression in patients with acute lung injury

Abstract

Purpose:The aim of this study was to explore the value of the combination between lung ultrasound score (LUS) and the expression of plasma miR-21-3p in predicting the prognosis of patients with acute lung injury (ALI). Patients and methods:A total of 136 ALI patients were divided into survival (n = 86) and death groups (n = 50), or into low/middle-risk (n = 77) and high-risk groups (n = 59) according to APACHE II scores. Bioinformatics was used to explore the mechanism of action of miR-21-3p in humans. Real-time fluorescent quantitative PCR was used to detect the expression of miR-21-3p in plasma, and LUS was recorded. Receiver operator characteristic (ROC) curve and Pearson correlation were also used. Results:The LUS and expression level of plasma miR-21-3p in the death and highrisk groups were significantly higher than those in the survival and low/middle-risk groups (p < 0.01 and p < 0.05). miR-21-3p expression leads to pulmonary fibrosis and promotes the deterioration of ALI patients by regulating fibroblast growth factor and other target genes. ROC curve analysis showed that the best cutoff values for LUS and plasma miR-21-3p expression were 18.60 points and 1.75, respectively. LUS score and miR-21-3p combined predicted the death of ALI patients with the largest area under the curve (0.907, 95% CI: 0.850-0.964), with sensitivity and specificity of 91.6% and 85.2%, respectively. The expression level of plasma miR-21-3p was positively correlated with LUS in the death group (r = 0.827, p < 0.01). Conclusion:LUS and expression level of miR-21-3p in plasma are correlated with the severity and prognosis of ALI patients, and their combination has a high value for the prognostic assessment of ALI patients.

Evaluation of the prognostic value of lncRNA UCA1 combined with extravascular lung water index and lung ultrasound score in patients with acute lung injury

“…Li et al document that LUS combined with other three indicators had high efficacy in predicting the prognosis of ALI patients 29 . The combination of miR‐21‐3p and LUS is involved in the aggression and overall outcome of patients with ALI, reflecting that the expression of miRNA may correlate with LUS in ALI 30 . The expression of UCA1 is elevated in patients with ARDS, and knockdown of UCA1 can reduce lung injury through inhibiting inflammatory response, reflecting that UCA1 is involved in ALI 31 .…”

Descriptive and Functional Genomics in Neonatal Respiratory Distress Syndrome: From Lung Development to Targeted Therapies

“…Furthermore, the LUS and the plasma expression level of miR-21-3p exhibit a correlation with the severity and prognosis of patients with acute lung injury. When used in combination, these two factors hold significant value in assessing the prognosis of patients with acute lung injury [ 161 ]. These investigations are in the initial exploratory phase, and additional prospective studies are required to conclusively establish the significance of miRNAs in conjunction with the LUS for neonatal patients with RDS.…”

Acute Lung Injury in aortic dissection : new insights in anesthetic management strategies

“…Lung ultrasound is used to evaluate the lung areas, including bilateral, lateral, upper, and lower posterior chest walls, to provide a point score based on the severity of lung tissues: lung consolidation = 3 points, severely reduced lung ventilation area = 2 points; moderately reduced lung ventilation area = 1 point; normal ventilation area = 0 points. The cutoff values for the LUS score in ALI patients are 18.6 points [41,42]. As PaO2/FiO2 changes occur after the lung ventilation area change, the LUS can well reflect lung changes and evaluate ALI severity.…”