Biomarkers in Pediatric ARDS: Future Directions

Orwoll, Benjamin E.; Sapru, Anil

Proteins and other biomarkers measured in blood or BAL fluid that have been reported in the literature and have the potential to serve as biological markers are presented here in a systematic manner based on their pathogenesis: inflammation, coagulation, epithelial, endothelial, surfactant, and non-protein markers. Plasma or serum biomarkers are favored in many instances over biomarkers from BAL fluid due to the relatively easy availability of blood samples. Additionally, in many instances, unstable patients with lung injury may not tolerate the BAL procedure. Plasma and serum biomarkers that have been studied in the pediatric or neonatal populations are presented in Table 1 and BAL fluid markers in Table 2 . Most biomarkers studied to date are protein-based, but we will also discuss several non-protein biomarker groups that have the potential to add to our understanding of pARDS.