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Maintaining the normal function of the pulmonary microvascular barrier is critical for ARDS treatment. To assess the relationship between the HAS2 protein level, HA content and the clinical prognosis of ARDS in patients with ARDS. Compare the HAS2 protein levels, HMW-HA and LMW-HA levels, endothelial injury indicators, and lungs in the blood of severe and non-ARDS severe patients and healthy adults admitted to the ICU. The correlation between permeability, disease severity and prognosis to explore the predictability of HAS2-HA on the clinical outcome of ARDS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ARDS group | 1.85 years≥Age≥18 years. 2.Moderate-to-severe ARDS, defined by the ARDS Definition Task Force in the Berlin definition (partial pressure of arterial oxygen [PaO2]:FiO2 ratio ≤200 mmHg with a PEEP ≥5 cmH2O). 3.Diagnosis of ARDS less than 72 hours. 4.Just observation | ||
| Critically ill patients without ARDS group | Unstable vital signs, rapid changes in the condition, unstable function of more than two organ systems (excluding the respiratory system), decline or failure, the development of the disease may endanger the life of the patient. | ||
| healthy adult group | Healthy adults, voluntarily join the study. |
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| Measure | Description | Time Frame |
|---|---|---|
| 28-day fatality Rate | 28-day mortality (patients will be followed for 28 days) | 28 days after enrollment |
| 90-day fatality rate | 90-day mortality (patients will be followed for 90 days) | 90 days after enrollment |
| ICU hospital stay | Length of ICU stay | through study completion, an average of 4 week |
| ICU fatality rate | The ratio of the total number of deaths from all causes of the enrolled patients during ICU hospitalization. | through study completion, an average of 4 week |
| Wearing time from mechanical ventilation | successful weaning defined as the absence of the requirement for ventilatory support, without reintubation | through study completion，an average of 4 week |
| Peripheral blood HMW-HA and LMW-HA levels | ELISA method to separate and detect HMW-HA and LMW-HA levels（Units of Measure unit nM/ml） | 0, 1, 3, 7 days after enrollment |
| HAS2 protein content in peripheral blood | ELISA method detects HAS2 protein in peripheral blood | 0, 1, 3, 7 days after enrollment |
| Measure | Description | Time Frame |
|---|---|---|
| ENOS, ET-1, vWF levels in peripheral blood | ELISA method to detect eNOS, ET-1, vWF in peripheral blood to evaluate endothelial cell damage（Measure unit ng/ml） | 0, 1, 3, 7 days after enrollment |
| Levels of bound mucinoglycans-1, nitric oxide, and acetylheparin sulfate in peripheral blood |
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Inclusion Criteria:
1.85 years≥Age≥18 years. 2.Moderate-to-severe ARDS, defined by the ARDS Definition Task Force in the Berlin definition (partial pressure of arterial oxygen [PaO2]:FiO2 ratio ≤200 mmHg with a PEEP ≥5 cmH2O).
3.Diagnosis of ARDS less than 72 hours.
Exclusion Criteria:
All patients who meet any of the following criteria will be excluded at enrollment and randomization.
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1.85 years≥Age≥18 years. 2.Moderate-to-severe ARDS, defined by the ARDS Definition Task Force in the Berlin definition (partial pressure of arterial oxygen [PaO2]:FiO2 ratio ≤200 mmHg with a PEEP ≥5 cmH2O).
3.Diagnosis of ARDS less than 72 hours.
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| ID | Term |
|---|---|
| D012128 | Respiratory Distress Syndrome |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
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whole blood samples
glycocalyx levels of the endothelium were assessed by measuring the levels of mucin polysaccharide-1, nitric oxide and acetyl heparan sulfate in peripheral blood by ELISA assay（Measure unit ng/ml） |
| 0, 1, 3, 7 days after enrollment |
| In peripheral blood, IL-1α, IL-6, neutrophils, lymphocytes, descending Procalcin, C-reactive protein value | The ELISA method detects IL-1α and IL-6 in the blood, and records the blood neutrophils, lymphocytes, and vary in procalcin and C-reactive protein to assess the inflammatory response of ARDS(Measure unit pg/ml） | 0, 1, 3, 7 days after enrollment |