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Clinical Investigations in Critical CarePolymorphism in the Surfactant Protein-B Gene, Gender, and the Risk of Direct Pulmonary Injury and ARDS
Section snippets
Study Population
We conducted a nested case control study in the neurologic, cardiac, medical, and surgical ICUs of the Massachusetts General Hospital (Boston, MA). Every weekday, the research coordinator screens all patients admitted to the ICU in the preceding 24 h for ARDS risk factors, as defined in Table 1. For patients admitted to the ICU with sepsis or severe sepsis, clinical data on the suspected source of infection was collected. Patients were considered to have pneumonia as a source of sepsis if they
Cohort Characteristics
From October 1999 to April 2000 and from June to September 2000, 2,294 consecutive patients admitted to the ICU were screened. A total of 428 patients were admitted to the ICU with one or more of the required risk factors for ARDS. Of those, 188 patients were excluded and 46 patients either refused consent or died before consent could be obtained, resulting in 194 patients being enrolled into the cohort. In addition, nine patients were enrolled as part of the pilot study between January and
Discussion
The limitations of this study should be mentioned. As this was a preliminary report, the study is small. Thus, confirmatory studies on a larger group of patients will need to be performed. The critical presentation of many of the patients and the inability to interview them for clinical history limits the ability to obtain data for certain parameters such as tobacco history, which were missing for 78 patients. To our knowledge, the variant SP-B genotype has not been associated previously with
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This research was supported by research grants HL60710 and ES00002 from the National Institutes of Health. Dr. Gong was supported by grant K23 HL67197 from the National Heart, Lung, and Blood Institute, and Drs. Xu and Miller were supported by grant T32 ES07069 from the National Institute of Environmental Health Sciences.