Assessment of Serum Uric Acid and Highly Sensitive C-reactive Protein in Patients with Acute Respiratory Distress Syndrome

Abstract

Abstract: Background: Acute respiratory distress syndrome (ARDS) is characterized by the acute onset of pulmonary edema of non-cardiogenic origin, along with bilateral pulmonary infiltrates and reduction in respiratory system compliance with refractory hypoxemia that is the hallmark of the syndrome. Objectives: This study is designed for the assessment of serum uric acid (SUA)and highly sensitive C-reactive protein (HSCRP) in patients with ARDS and for the determination of risk factors promotes the induction of ARDS.Subjects and methods: This case control study was conducted in Al-Batool Teaching Hospital for Maternity and Children for the period from August 2017 to June 2018. 200 subjects were included, 100 patients who were admitted to neonate intensive care unit with age range 1-2 days. Another 100 age and sex matched apparently healthy infants were included as control group. A specific questionnaire form was preconstructed for this purpose. Blood samples were collected from subjects. Sera were separated and the determination of serum uric acid was carried out by (COBAS INTEGRA systems, Germany) The determination of highly sensitive C-reactive protein was measured by (COBAS INTEGRA systems, Germany) Human privacy was respected by taken patient's parents consent. Furthermore, the study was approved by the Ethical Committee in the College of Medicine.Results: The results revealed that the mean ± SD of serum uric acid in patients was significantly higher than that of controls (328.52 ± 151.19 versus 264.15 ± 85.12, t-test = 3.71, P = 0.001). Similarly, the mean ± SD of highly sensitive C-reactive protein titer was significantly elevated in neonates with respiratory distress syndrome versus controls (5.19 ± 16.11 versus 1.3 ± 1.7, t-test = 2.398, P= 0.017). The SUA was significantly higher in patients weighted less than 2.5 Kgs (t-test = 2.688, P= 0.008). Furthermore, preterm patients had significantly higher SUA (t-test = 2.435, P = 0.017). The results also found that patients who required medical intervention had higher levels of SUA (t-test = 2.395, P = 0.024). Additionally, patients who were dead had significantly higher titer of SUA (t-test = 8.545, P = 0.001). While other factors including gender and age showed insignificant effect. Concerning the HSCRP, preterm patients had significantly higher titers versus term patients (t-test = 2.066, P = 0.042). However, other factors including gender, age, weight, intervention required and final outcome were failed to reach the levels of statistical significance.Conclusion: The study concluded that the serum uric acid concentration and the highly sensitive C-reactive protein titer can be employed as diagnostic adjuncts for RDS in newly born infants, and certain patient's and mother's features were significantly associated with these markers.