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Prevalence and impact of active and passive cigarette smoking in acute respiratory distress syndrome.
Crit Care Med. 2014 Sep; 42(9):2058-68.CC

Abstract

OBJECTIVES

Cigarette smoke exposure has recently been found to be associated with increased susceptibility to trauma- and transfusion-associated acute respiratory distress syndrome. We sought to determine 1) the incidence of cigarette smoke exposure in a diverse multicenter sample of acute respiratory distress syndrome patients and 2) whether cigarette smoke exposure is associated with severity of lung injury and mortality in acute respiratory distress syndrome.

DESIGN

Analysis of the Albuterol for the Treatment of Acute Lung Injury and Omega Acute Respiratory Distress Syndrome Network studies.

SETTING

Acute Respiratory Distress Syndrome Network hospitals.

PATIENTS

Three hundred eighty-one patients with acute respiratory distress syndrome.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol, a validated tobacco-specific marker, was measured in urine samples from subjects enrolled in two National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network randomized controlled trials. Urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol levels were consistent with active smoking in 36% of acute respiratory distress syndrome patients and with passive smoking in 41% of nonsmokers (vs 20% and 40% in general population, respectively). Patients with 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol levels in the active smoking range were younger and had a higher incidence of alcohol misuse, fewer comorbidities, lower severity of illness, and less septic shock at enrollment compared with patients with undetectable 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol levels. Despite this lower severity of illness, the severity of lung injury did not significantly differ based on biomarker-determined smoking status. Cigarette smoke exposure was not significantly associated with death after adjusting for differences in age, alcohol use, comorbidities, and severity of illness.

CONCLUSIONS

In this first multicenter study of biomarker-determined cigarette smoke exposure in acute respiratory distress syndrome patients, we found that active cigarette smoke exposure was significantly more prevalent among acute respiratory distress syndrome patients compared to population averages. Despite their younger age, better overall health, and lower severity of illness, smokers by 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol had similar severity of lung injury as patients with undetectable 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol. These findings suggest that active cigarette smoking may increase susceptibility to acute respiratory distress syndrome in younger, healthier patients.

Authors+Show Affiliations

1Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY. 2Cardiovascular Research Institute, University of California, San Francisco, CA. 3Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, CA. 4Center for Tobacco Control Research and Education, University of California, San Francisco, CA. 5Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 6Division of Nephrology, Department of Medicine, University of California, San Francisco, CA. 7Department of Anesthesia, University of California, San Francisco, CA. 8Division of Pulmonary and Critical Care, Department of Medicine, University of California, San Francisco, CA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24942512

Citation

Hsieh, S Jean, et al. "Prevalence and Impact of Active and Passive Cigarette Smoking in Acute Respiratory Distress Syndrome." Critical Care Medicine, vol. 42, no. 9, 2014, pp. 2058-68.
Hsieh SJ, Zhuo H, Benowitz NL, et al. Prevalence and impact of active and passive cigarette smoking in acute respiratory distress syndrome. Crit Care Med. 2014;42(9):2058-68.
Hsieh, S. J., Zhuo, H., Benowitz, N. L., Thompson, B. T., Liu, K. D., Matthay, M. A., & Calfee, C. S. (2014). Prevalence and impact of active and passive cigarette smoking in acute respiratory distress syndrome. Critical Care Medicine, 42(9), 2058-68. https://doi.org/10.1097/CCM.0000000000000418
Hsieh SJ, et al. Prevalence and Impact of Active and Passive Cigarette Smoking in Acute Respiratory Distress Syndrome. Crit Care Med. 2014;42(9):2058-68. PubMed PMID: 24942512.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and impact of active and passive cigarette smoking in acute respiratory distress syndrome. AU - Hsieh,S Jean, AU - Zhuo,Hanjing, AU - Benowitz,Neal L, AU - Thompson,B Taylor, AU - Liu,Kathleen D, AU - Matthay,Michael A, AU - Calfee,Carolyn S, AU - ,, AU - ,, PY - 2014/6/20/entrez PY - 2014/6/20/pubmed PY - 2014/10/15/medline SP - 2058 EP - 68 JF - Critical care medicine JO - Crit Care Med VL - 42 IS - 9 N2 - OBJECTIVES: Cigarette smoke exposure has recently been found to be associated with increased susceptibility to trauma- and transfusion-associated acute respiratory distress syndrome. We sought to determine 1) the incidence of cigarette smoke exposure in a diverse multicenter sample of acute respiratory distress syndrome patients and 2) whether cigarette smoke exposure is associated with severity of lung injury and mortality in acute respiratory distress syndrome. DESIGN: Analysis of the Albuterol for the Treatment of Acute Lung Injury and Omega Acute Respiratory Distress Syndrome Network studies. SETTING: Acute Respiratory Distress Syndrome Network hospitals. PATIENTS: Three hundred eighty-one patients with acute respiratory distress syndrome. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol, a validated tobacco-specific marker, was measured in urine samples from subjects enrolled in two National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network randomized controlled trials. Urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol levels were consistent with active smoking in 36% of acute respiratory distress syndrome patients and with passive smoking in 41% of nonsmokers (vs 20% and 40% in general population, respectively). Patients with 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol levels in the active smoking range were younger and had a higher incidence of alcohol misuse, fewer comorbidities, lower severity of illness, and less septic shock at enrollment compared with patients with undetectable 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol levels. Despite this lower severity of illness, the severity of lung injury did not significantly differ based on biomarker-determined smoking status. Cigarette smoke exposure was not significantly associated with death after adjusting for differences in age, alcohol use, comorbidities, and severity of illness. CONCLUSIONS: In this first multicenter study of biomarker-determined cigarette smoke exposure in acute respiratory distress syndrome patients, we found that active cigarette smoke exposure was significantly more prevalent among acute respiratory distress syndrome patients compared to population averages. Despite their younger age, better overall health, and lower severity of illness, smokers by 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol had similar severity of lung injury as patients with undetectable 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol. These findings suggest that active cigarette smoking may increase susceptibility to acute respiratory distress syndrome in younger, healthier patients. SN - 1530-0293 UR - https://www.unboundmedicine.com/medline/citation/24942512/full_citation L2 - https://dx.doi.org/10.1097/CCM.0000000000000418 DB - PRIME DP - Unbound Medicine ER -