Evaluation Of CLI In The Early Diagnosis Of Sepsis With ARDS

Objective: To explore the clinical value of capillary leakage index(CLI)in prediction the septic patients with Acute Respiratory Distress Syndrome(ARDS).Methods: Clinical data of 288 septic patients from January 2014 to April 2016 in ICU ward of our hospital were retrospective analyzed.Serum C-reactive protein(CRP),albumin(ALB)and other Physical and laboratory indexes were collected on admission.According to the occurrence of ARDS or not,the patients were divided into ARDS group and non-ARDS group.The clinical data between two groups were compared.The significant varieties were analyzed using Logistic regression to determine the independent predictors for sepsis with ARDS.Discrimination of the independent predictors was assessed with the areas under the receiver operating characteristics(ROC)curve(AUC).Results: 288 cases of septic patients were included.There were no differences of age,sex,underlying diseases and infection sites between two groups(P>0.05).Compared with non-ARDS group,the Lactate,CRP,CLI,LIPS,PCT,IL-6,APACHEII score,SOFA score and mortality were significant high in ARDS group and ALB was significant low in ARDS group(P<0.05).It was identified by Logistic regression that CLI,LIPS were significantly independent factors in prediction septic patients with ARDS(P<0.05).It was shown by area under ROC(AUC)that the predictive value of CLI and LIPS in ARDS occurrence was significant.AUC of CLI was 0.807(95% CI: 0.757 – 0.856),the cut-off value was 4.99,when LIPS ? 4.99,the sensitivity was 86.3%,specificity was 63.4%.AUC of LIPS was 0.823(95% CI 0.775 – 0.870),the cut-off value was 5.25,when LIPS ?5.25,the sensitivity was 91.1% and specificity was 58.5%.Conclusions: CLI is simplified and can be a good indicator for the early diagnosis of sepsis with ARDS.