ASSOCIATION BETWEEN SERUM TNF-ALPHA LEVELS AND DISEASE SEVERITY IN PATIENTS WITH ARDS AT CAN THO CENTRAL GENERAL HOSPITAL IN 2025-2026
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Abstract
Background: Acute respiratory distress syndrome (ARDS) is a rapidly progressive injury of the pulmonary parenchyma associated with a systemic inflammatory response. However, the role of serum Tumor Necrosis Factor-alpha (TNF-α) in predicting ARDS severity remains unclear. Objectives: To determine the association between serum TNF-α levels at ICU admission and ARDS severity, as classified by the PaO₂/FiO₂ ratio, and to evaluate the predictive value of serum TNF-α for severe ARDS. Materials and methods: A descriptive cross-sectional study was conducted in 43 patients diagnosed with ARDS according to the Global Definition 2024. Clinical data and serum TNF-α were collected at the time of diagnosis (T0), and the PaO2/FiO2 (P/F) ratio was recorded at T0, T12, T24, and T48. Patients were classified into mild–moderate ARDS and severe ARDS groups (P/F <100). Results: TNF-α levels were significantly higher in the severe ARDS group compared with the mild–moderate group (8.20 vs 5.14 pg/mL, p <0.001). TNF-α showed an inverse correlation with the P/F ratio (r = −0.73, p <0.001). Patients with TNF-α levels above the median had lower P/F ratios at T0, T12, and T24 (p <0.05), but the difference was no longer significant after 48 hours. TNF-α was a predictor of severe ARDS (adjusted OR 2.89; 95% CI: 1.25–6.69; p = 0.013) with an AUC of 0.88 (95% CI: 0.78–0.98); at the optimal cutoff of 6.15 pg/mL, sensitivity was 92% and specificity was 71%. Conclusion: Serum TNF-α has value in predicting ARDS severity.
Keywords
ARDS, TNF-α, PaO2/FiO2, severity prediction
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