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ORIGINAL RESEARCH article

Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1510788
This article is part of the Research Topic Lung Cross-talk in Acute Respiratory Failure View all articles

Predictive value of the monocyte count for determining the risk of postoperative moderate-to-severe ARDS in patients undergoing one-lung ventilation during radical treatment of esophageal cancer

Provisionally accepted
Feng Zhang Feng Zhang 1,2Shunmei Lu Shunmei Lu 2Guilong Wang Guilong Wang 2*Hongyang Xu Hongyang Xu 2Dongxiao Huang Dongxiao Huang 3*Xiaomin Li Xiaomin Li 1*
  • 1 Lianyungang Clinical Medical College, Nanjing Medical University, Lianyungang, China
  • 2 Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu Province, China
  • 3 Jiangnan University Medical Center (JUMC）, Wuxi, Liaoning Province, China

The final, formatted version of the article will be published soon.

    Background: This study aimed to screen for risk factors and to assess the predictive value of the monocyte count for the development of moderate-to-severe acute respiratory distress syndrome (ARDS) in patients undergoing one-lung ventilation (OLV) during radical surgery for esophageal cancer.In this retrospective study, patients with esophageal cancer admitted to the Department of Thoracic Surgery of Wuxi People's Hospital between January 2017 and January 2021 were selected. Demographic, preoperative, intraoperative, and postoperative (within 2 h) data were collected.Patients were categorized into moderate-to-severe ARDS and non-moderate-to-severe ARDS groups.Multifactorial logistic regression, receiver operating characteristic (ROC), curve-fitting, and Spearman correlation analysis were used to analyze the data.Results:After screening, 255 patients were enrolled, with 18% in moderate-to-severe ARDS group.Regression analysis revealed that postoperative monocyte count was an independent predictor for severe ARDS after surgery (OR=2.916, 95% CI: 1.082-7.863, p < 0.05). The optimal cut-off value of postoperative monocyte count in predicting moderate-to-severe ARDS was 0.56×10 9 /L (AUC=0.708) with a sensitivity of 67.4% and a specificity of 66.5%. The difference of predictive value between postoperative monocyte count and prediction model (AUC=0.760) was not statistically significant (P=0.142). Additionally, a nonlinear connection between postoperative monocyte count and severe ARDS was found using curve fitting.The postoperative monocyte count is an ideal predictor of postoperative moderate-to-severe ARDS in this patient population and can be used for the early diagnosis of patients with severe postoperative ARDS.

    Keywords: ARDS, monocyte, esophageal cancer, OLV, predictive, postoperative

    Received: 13 Oct 2024; Accepted: 23 Jan 2025.

    Copyright: © 2025 Zhang, Lu, Wang, Xu, Huang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Guilong Wang, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, 211166, Jiangsu Province, China
    Dongxiao Huang, Jiangnan University Medical Center (JUMC）, Wuxi, Liaoning Province, China
    Xiaomin Li, Lianyungang Clinical Medical College, Nanjing Medical University, Lianyungang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.