Cigarette Smoke Exposure and Acute Respiratory Distress Syndrome in Sepsis : Epidemiology, Clinical Features, and Biologic Markers
Rationale: Cigarette smoke exposure is associated with an increased risk of developing acute respiratory distress syndrome (ARDS) in trauma, transfusion, and nonpulmonary sepsis. It is unknown whether this relationship exists in the general sepsis population. Furthermore, it is unknown if patients with ARDS have differences in underlying biology based on smoking status. Objectives: To assess the relationship between cigarette smoke exposure and ARDS in sepsis and identify tobacco-related biomarkers of lung injury. Methods: We studied a prospective cohort of 592 patients with sepsis from 2009 to 2017. Plasma cotinine and urine NNAL [urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol] were measured to categorize smoking status. Plasma biomarkers of inflammation and lung injury were measured, including in a smaller cohort of trauma patients with ARDS to increase generalizability. Measurements and Main Results: Passive and active smoking were associated with increased odds of developing ARDS in patients with sepsis. Among patients with sepsis and ARDS, active cigarette smokers were younger and had lower severity of illness than nonsmokers. Patients with ARDS with cigarette smoke exposure had lower plasma levels of IL-8 (P = 0.01) and sTNFR-1 (soluble tumor necrosis factor 1; P = 0.01) compared with those without exposure. Similar biomarker patterns were observed in blunt trauma patients with ARDS. Conclusions: Passive and active smoking are associated with an increased risk of developing ARDS in patients with pulmonary and nonpulmonary sepsis. Among patients with ARDS, those with cigarette smoke exposure have less systemic inflammation, while active smokers also have lower severity of illness compared with nonsmokers, suggesting that smoking contributes to biological heterogeneity in ARDS.
| Errataetall: |
CommentIn: Am J Respir Crit Care Med. 2022 Apr 15;205(8):866-867. - PMID 35130469 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:205 |
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| Enthalten in: |
American journal of respiratory and critical care medicine - 205(2022), 8 vom: 15. Apr., Seite 927-935 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Moazed, Farzad [VerfasserIn] |
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| Links: |
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| Themen: |
ARDS |
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| Anmerkungen: |
Date Completed 19.04.2022 Date Revised 16.04.2023 published: Print CommentIn: Am J Respir Crit Care Med. 2022 Apr 15;205(8):866-867. - PMID 35130469 Citation Status MEDLINE |
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| doi: |
10.1164/rccm.202105-1098OC |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM335854915 |
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| 100 | 1 | |a Moazed, Farzad |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cigarette Smoke Exposure and Acute Respiratory Distress Syndrome in Sepsis |b Epidemiology, Clinical Features, and Biologic Markers |
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| 500 | |a Date Completed 19.04.2022 | ||
| 500 | |a Date Revised 16.04.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Am J Respir Crit Care Med. 2022 Apr 15;205(8):866-867. - PMID 35130469 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Rationale: Cigarette smoke exposure is associated with an increased risk of developing acute respiratory distress syndrome (ARDS) in trauma, transfusion, and nonpulmonary sepsis. It is unknown whether this relationship exists in the general sepsis population. Furthermore, it is unknown if patients with ARDS have differences in underlying biology based on smoking status. Objectives: To assess the relationship between cigarette smoke exposure and ARDS in sepsis and identify tobacco-related biomarkers of lung injury. Methods: We studied a prospective cohort of 592 patients with sepsis from 2009 to 2017. Plasma cotinine and urine NNAL [urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol] were measured to categorize smoking status. Plasma biomarkers of inflammation and lung injury were measured, including in a smaller cohort of trauma patients with ARDS to increase generalizability. Measurements and Main Results: Passive and active smoking were associated with increased odds of developing ARDS in patients with sepsis. Among patients with sepsis and ARDS, active cigarette smokers were younger and had lower severity of illness than nonsmokers. Patients with ARDS with cigarette smoke exposure had lower plasma levels of IL-8 (P = 0.01) and sTNFR-1 (soluble tumor necrosis factor 1; P = 0.01) compared with those without exposure. Similar biomarker patterns were observed in blunt trauma patients with ARDS. Conclusions: Passive and active smoking are associated with an increased risk of developing ARDS in patients with pulmonary and nonpulmonary sepsis. Among patients with ARDS, those with cigarette smoke exposure have less systemic inflammation, while active smokers also have lower severity of illness compared with nonsmokers, suggesting that smoking contributes to biological heterogeneity in ARDS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a ARDS | |
| 650 | 4 | |a biomarkers | |
| 650 | 4 | |a cigarette smoking | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 650 | 7 | |a Tobacco Smoke Pollution |2 NLM | |
| 700 | 1 | |a Hendrickson, Carolyn |e verfasserin |4 aut | |
| 700 | 1 | |a Jauregui, Alejandra |e verfasserin |4 aut | |
| 700 | 1 | |a Gotts, Jeffrey |e verfasserin |4 aut | |
| 700 | 1 | |a Conroy, Amanda |e verfasserin |4 aut | |
| 700 | 1 | |a Delucchi, Kevin |e verfasserin |4 aut | |
| 700 | 1 | |a Zhuo, Hanjing |e verfasserin |4 aut | |
| 700 | 1 | |a Arambulo, Mikhaela |e verfasserin |4 aut | |
| 700 | 1 | |a Vessel, Kathryn |e verfasserin |4 aut | |
| 700 | 1 | |a Ke, Serena |e verfasserin |4 aut | |
| 700 | 1 | |a Deiss, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Ni, Amy |e verfasserin |4 aut | |
| 700 | 1 | |a Leligdowicz, Aleksandra |e verfasserin |4 aut | |
| 700 | 1 | |a Abbott, Jason |e verfasserin |4 aut | |
| 700 | 1 | |a Cohen, Mitchell J |e verfasserin |4 aut | |
| 700 | 1 | |a Sinha, Pratik |e verfasserin |4 aut | |
| 700 | 1 | |a Gomez, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Kangelaris, Kirsten |e verfasserin |4 aut | |
| 700 | 1 | |a Kornblith, Lucy |e verfasserin |4 aut | |
| 700 | 1 | |a Matthay, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Benowitz, Neal |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Kathleen |e verfasserin |4 aut | |
| 700 | 1 | |a Calfee, Carolyn S |e verfasserin |4 aut | |
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