Exposure to ambient air pollutants and acute respiratory distress syndrome risk in sepsis

Purpose Exposures to ambient air pollutants may prime the lung enhancing risk of acute respiratory distress syndrome (ARDS) in sepsis. Our objective was to determine the association of short-, medium-, and long-term pollutant exposures and ARDS risk in critically ill sepsis patients. Methods We analyzed a prospective cohort of 1858 critically ill patients with sepsis, and estimated short- (3 days), medium- (6 weeks), and long- (5 years) term exposures to ozone, nitrogen dioxide ($ NO_{2} $), sulfur dioxide ($ SO_{2} $), carbon monoxide (CO), particulate matter < 2.5 μm ($ PM_{2.5} $), and PM < 10 μm ($ PM_{10} $) using weighted averages of daily levels from monitors within 50 km of subjects’ residences. Subjects were followed for 6 days for ARDS by the Berlin Criteria. The association between each pollutant and ARDS was determined using multivariable logistic regression adjusting for preselected confounders. In 764 subjects, we measured plasma concentrations of inflammatory proteins at presentation and tested for an association between pollutant exposure and protein concentration via linear regression. Results ARDS developed in 754 (41%) subjects. Short- and long-term exposures to $ SO_{2} $, $ NO_{2} $, and $ PM_{2.5} $ were associated with ARDS risk ($ SO_{2} $: odds ratio (OR) for the comparison of the 75–25th long-term exposure percentile 1.43 (95% confidence interval (CI) 1.16, 1.77); p < 0.01; $ NO_{2} $: 1.36 (1.06, 1.74); p = 0.04, $ PM_{2.5} $: 1.21 (1.04, 1.41); p = 0.03). Long-term exposures to these three pollutants were also associated with plasma interleukin-1 receptor antagonist and soluble tumor necrosis factor receptor-1 concentrations. Conclusion Short and long-term exposures to ambient $ SO_{2} $, $ PM_{2.5} $, and $ NO_{2} $ are associated with increased ARDS risk in sepsis, representing potentially modifiable environmental risk factors for sepsis-associated ARDS..

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:49

Enthalten in:

Intensive care medicine - 49(2023), 8 vom: 20. Juli, Seite 957-965

Sprache:

Englisch

Beteiligte Personen:

Reilly, John P. [VerfasserIn]
Zhao, Zhiguo [VerfasserIn]
Shashaty, Michael G. S. [VerfasserIn]
Koyama, Tatsuki [VerfasserIn]
Jones, Tiffanie K. [VerfasserIn]
Anderson, Brian J. [VerfasserIn]
Ittner, Caroline A. [VerfasserIn]
Dunn, Thomas [VerfasserIn]
Miano, Todd A. [VerfasserIn]
Oniyide, Oluwatosin [VerfasserIn]
Balmes, John R. [VerfasserIn]
Matthay, Michael A. [VerfasserIn]
Calfee, Carolyn S. [VerfasserIn]
Christie, Jason D. [VerfasserIn]
Meyer, Nuala J. [VerfasserIn]
Ware, Lorraine B. [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

BKL:

44.69$jIntensivmedizin

Themen:

Acute lung injury
Acute respiratory distress syndrome
Air pollution
Sepsis

RVK:

RVK Klassifikation

Anmerkungen:

© Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:

10.1007/s00134-023-07148-y

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2144999759

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