Evaluation of the role of human neutrophil elastase, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio as predictive markers for severity of acute respiratory toxicity among patients admitted to Poison Control Center of Ain Shams University Hospitals.

BACKGROUND

There are hundreds of xenobiotics that can damage the respiratory system, necessitating mechanical ventilation. Therefore, acute respiratory toxicity may represent a serious condition that can be complicated by acute respiratory distress syndrome (ARDS). This study aimed to evaluate the role of Human Neutrophil Elastase (HNE) as a predictor of acute respiratory toxicity outcome and to compare it with the neutrophil lymphocyte ratio (N/L ratio) and platelet lymphocyte ratio (P/L ratio).

METHODS

This prospective study was conducted on adult patients with acute respiratory toxicity admitted to Poison Control Center; Ain Shams University Hospitals from January 2022 to December 2022. Their HNE, N/L ratio, and P/L ratio levels were assessed twice: First upon admission and again 24 h later.

RESULTS

Fifty-five patients were enrolled in the study and were classified into ARDS group and non-ARDS group. HNE levels were significantly higher in ARDS patients at both time points with excellent predictive performance. Although the N/L and P/L ratios were significantly elevated in ARDS patients at 30 h, their diagnostic performance was inferior to HNE. Combining HNE with the N/L ratio offered minimal additional benefit over HNE alone.

CONCLUSION

HNE Level can serve as predictor of ARDS in acutely intoxicated patients.