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01.11.2005 | Original

Serial changes in soluble triggering receptor expressed on myeloid cells in the lung during development of ventilator-associated pneumonia

verfasst von: Rogier M. Determann, Julian L. Millo, Sébastien Gibot, Johanna C. Korevaar, Margreeth B. Vroom, Tom van der Poll, Christopher S. Garrard, Marcus J. Schultz

Erschienen in: Intensive Care Medicine | Ausgabe 11/2005

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Abstract

Objective

To determine the diagnostic role of soluble triggering receptor expressed on myeloid cells (sTREM)-1 in non-directed bronchial lavage fluid in ventilator-associated pneumonia (VAP).

Design

Non-directed bronchial lavage fluid and plasma were collected on alternate days in critically ill mechanically ventilated patients from the start of ventilatory support until complete weaning from the ventilator. Soluble TREM-1 levels were measured by an enzyme-linked immunosorbent assay.

Setting

A general adult medical and surgical university hospital intensive care unit.

Patients

Nine patients who developed VAP and 19 patients who did not develop VAP (controls).

Results

Plasma levels of sTREM-1 did not change significantly in either patient group. While in controls concentrations of sTREM-1 in non-directed bronchial lavage fluid did not change significantly over time, in patients who developed VAP levels of sTREM-1 in non-directed bronchial lavage fluid increased towards the diagnosis of VAP. A cut-off value for non-directed bronchial lavage fluid sTREM-1 levels of 200 pg/ml on the day of VAP had a diagnostic sensitivity of 75% and a specificity of 84%. Sensitivity increased when taking into account all sTREM-1 levels higher than 200 pg/ml from the 6-day period before the day of diagnosis that were preceded by an increase of at least 100 pg/ml (sensitivity 88%, specificity 84%).

Conclusions

Soluble TREM-1 is a potential biomarker of VAP.

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Titel: Serial changes in soluble triggering receptor expressed on myeloid cells in the lung during development of ventilator-associated pneumonia
verfasst von: Rogier M. Determann
Julian L. Millo
Sébastien Gibot
Johanna C. Korevaar
Margreeth B. Vroom
Tom van der Poll
Christopher S. Garrard
Marcus J. Schultz
Publikationsdatum: 01.11.2005
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 11/2005
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-005-2818-7

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Serial changes in soluble triggering receptor expressed on myeloid cells in the lung during development of ventilator-associated pneumonia