• Christophe Guervilly, Romaric Lacroix, Jean-Marie Forel, Antoine Roch, Laurence Camoin-Jau, Laurent Papazian, and Françoise Dignat-George.
• Réanimation Médicale-Détresses Respiratoires Aigües-Infections Sévères, URMITE CNRS-UMR 6236, Hôpital Nord, Assistance Publique, Hôpitaux de Marseille, Chemin des Bourrely, 13015 Marseille, France. christophe.guervilly@ap-hm.fr
• Crit Care. 2011 Jan 1;15(1):R31.

IntroductionThe current study has addressed the presence and the cellular origin of microparticles (MP) isolated from bronchoalveolar lavage (BAL) fluid and from blood samples from patients with acute respiratory distress syndrome (ARDS). Their prognostic interest was also investigated.MethodsFifty-two patients were included within the first 24 hours of ARDS. They were compared to spontaneous breathing (SB) and ventilated control (VC) groups. Bronchoalveolar lavage (BAL) and blood samples were obtained on Day 1 and Day 3 in an ARDS group. Leukocyte microparticles (LeuMP), neutrophil microparticles (NeuMP), endothelial microparticles (EMP), and platelet microparticles (PMP) were measured in arterial blood and in BAL samples by flow cytometry. Mortality from all causes was recorded at Day 28.ResultsAll MP subpopulations were detected in BAL. However, only LeuMP and NeuMP were elevated in ARDS patients compared to the SB group (P = 0.002 for both). Among ARDS patients, higher levels of LeuMP were detected in blood (Day 1) and in BAL (Day 3) in survivors as compared with the non survivors. Circulating LeuMP >60 elements/microliter detectable on Day 1 of ARDS, was associated with a higher survival rate (odds ratio, 5.26; 95% confidence interval, 1.10 to 24.99; P = 0.037).ConclusionsThe identification of the cellular origin of microparticles at the onset of ARDS has identified LeuMP as a biomarker of prognostic significance. The higher levels of LeuMP in survivors could be associated with a protective role of this MP subpopulation. This hypothesis needs further investigations.

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