Diagnostic Performance of Soluble Triggering Receptor Expressed on Myeloid Cells-1 in Ventilator-Associated Pneumonia of Patients with Ischemic Stroke

الملخص EN

Objective.

To investigate the effect of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in serum, bronchoalveolar lavage fluid (BALF), endotracheal aspiration (ETA), and exhaled breath condensate (EBC) samples as early biomarkers for the diagnosis of ventilator-associated pneumonia (VAP) in patients with ischemic stroke.

Methods.

One hundred and thirty-two patients with clinically suspected VAP were enrolled in this study.

Bronchoscopy was performed on the day of clinically suspected VAP.

sTREM-1 levels in serum, BALF, ETA, and EBC were measured.

VAP was diagnosed by quantitative cultures of BALF (≥104 cfu/mL).

Results.

VAP was confirmed in 76 (57.58%) cases.

Patients with VAP showed significantly higher sTREM-1 in BALF [32.35 (IQR, 30.08–41.72) versus 18.92 (11.89–31.72)] pg/mL and in EBC [1.57 (IQR, 1.02–2.61) versus 0.41 (0.19–1.61)] pg/mL than patients without VAP.

The area under the curve was 0.813 (p<0.001).

The optimum cut-off value for sTREM-1 in BALF was 23.61 pg/mL, yielding sensitivity and specificity of 85.5% and 73.1%.

sTREM-1 in BALF had excellent correlation with that in EBC (R2 = 0.78, p<0.05).

Conclusions.

sTREM-1 in EBC and BALF had good diagnostic performance in differentiating patients with and without VAP.