Predict Severity And Prognosis In Patients With ARDS By Plasma Mitochondrial DNA:A Clinical Trial

Objective:To evaluate the predictive value of plasma mtDNA for ARDS severity and prognosis.Methods:We conducted a prospective study,From 1 May 2016 to 31 January 2017,patients diagnosed ARDS who meet the inclusion criteria were recruited into the study from the department of critical care medicine Zhongda Hospital,Southeast University.The inclusion criteria was patients who get ARDS within 48h.Demographic,clinical data,severity indices were recorded and blood plasma samples were subsequently collected.The enrolled day is defined as Day1,mtDNA levels in plasma on day1,day3 and day7 were quantified by quantitative real-time PCR.At the same time,arterial blood gas,C-reactive protein(CRP)and procalcitonin(PCT)on day1,day3 and day7 were tested.All objects were followed up till 28d and the 28d fatality rate,mechanical ventilation time,ICU length of stay were recorded.Evaluate the predictive value of different levels of mtDNA on day1,day3 and day7.Results:One hundred thirty-six patients with ARDS were screened,accroding to the inclusion criteria,73 patients with were enrolled finally,of the 73 patients,44 survived and 29 died(the 28 day mortality rate of 39.7%).Plasma mtDNA was positively related to the severity of ARDS.Plasma mtDNA level of patients who died within 28 days was significantly higher than that of survivals[67608copies/ul(19498-346736)vs.7585copies/ul(1717-15792),P<0.05].The plasma mtDNA level on dayl and day3 had no predictive value for prognosis,the plasma mtDNA level on day7 was predictive of prognosis,and the best predictive value was 18640copies/ul.Compared with the PaO2/FiO2,mtDNA has similar prognostic value in patients with ARDS.Conclusions:mtDNA level in plasma could reflect the severity of ARDS.Increased mtDNA levels are associated with ARDS patients outcomes.