Histidine-rich Glycoprotein Levels Associated

with 28-day Survival Rate in Acute Respiratory

Distress Syndrome and Disseminated
Intravascular Coagulation Patient.


Ayu N.K. Pradana, Tomohiko Akahoshi.

Abstract— Acute respiratory distress syndrome (ARDS) and

Disseminated Intravascular Coagulation (DIC) are two conditions
that can occur as a result of sepsis and are associated with high
mortality. During the septic condition, the level of Histidine-rich
glycoprotein (HRG) is decreased. Recent studies have shown that
administering HRG which is purified from human plasma to septic
mice increases the survival rate. HRG treatment reduced the number
of neutrophils in the lung, on which platelet aggregation and fibrin
deposit were observed. HRG also has a role in the regulatory process
of coagulation and fibrinolysis, as well as in the immune process in
sepsis.
This is a single-center, prospective, and observational study.
This study will be conducted on patients with ARDS and DIC who
are admitted to the ICU at Kyushu University Hospital. The blood
samples will be taken during day 1 and day 3 after the patient is
admitted to the ICU. The blood sample will then be processed and
examined using ELISA to measure the levels of HRG. The severity
of ARDS will be measure using Berlin Definitions of ARDS. DIC
scores will be measure using the new Japanese Association for Acute
Medicine (JAAM) score as well as The Sequential Organ Failure
Assessment (SOFA) score on day 1 and day 3. We will compare and
analyze the HRG level, the DIC scores, and the ratio of arterial
oxygen tension to the fraction of inspired oxygen (PaO2/FiO2) to
assess their correlations.
The purpose of this study is to analyze the use of HRG as a
prognostic tool in ARDS and DIC patients. The results of this study
are expected to be used as an indicator for evaluating patient
prognosis so that it can increase life expectancy and reduce mortality
from cases of ARDS and DIC patients.

Keywords— Acute respiratory distress syndrome(ARDS),

Disseminated intravascular coagulation (DIC), Histidine-rich
glycoprotein (HRG), Survival rate.


Ayu N.K. Pradana is with Department of Disaster and Emergency
Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka
812-8582 Japan (phone: 070-4446-7150; e-mail: ayu.nabila.767@s.kyushu-
u.ac.jp).
Tomohiko Akahoshi is with Department of Disaster and Emergency
Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka
812-8582 Japan (e-mail: akahoshi.tomohiko.006@m.kyushu-u.ac.jp).