Scopus: 16 cites, Google Scholar: cites
Tumor necrosis factor receptor 1 (TNFRI) for ventilator-associated pneumonia diagnosis by cytokine multiplex analysis
Martin-Loeches, Ignacio (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Bos, Lieuwe D.. (Department of Intensive Care and Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, University of Amsterdam)
Povoa, Pedro (Nova Medical School, CEDOC, New University of Lisbon)
Ramírez, Paula (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Schultz, Marcus J. (Department of Intensive Care and Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, University of Amsterdam)
Torres, Antoni (Hospital Universitari i Politècnic La Fe (València))
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Universitat Autònoma de Barcelona

Data: 2015
Resum: The diagnosis of ventilator-associated pneumonia (VAP) is challenging. An important aspect to improve outcome is early recognition of VAP and the initiation of the appropriate empirical treatment. We hypothesized that biological markers in plasma can rule out VAP at the moment of clinical suspicion and could rule in VAP before the diagnosis can be made clinically. In this prospective study, patients with VAP (n = 24, microbiology confirmed) were compared to controls (n = 19) with a similar duration of mechanical ventilation. Blood samples from the day of VAP diagnosis and 1 and 3 days before were analyzed with a multiplex array for markers of inflammation, coagulation, and apoptosis. The best biomarker combination was selected and the diagnostic accuracy was given by the area under the receiver operating characteristic curve (ROC-AUC). TNF-receptor 1 (TNFRI) and granulocyte colony-stimulating factor (GCSF) were selected as optimal biomarkers at the day of VAP diagnosis, which resulted in a ROC-AUC of 0. 96, with excellent sensitivity. Three days before the diagnosis TNFRI and plasminogen activator inhibitor-1 (PAI-1) levels in plasma predicted VAP with a ROC-AUC of 0. 79. The slope of IL-10 and PAI-1 resulted in a ROC-AUC of 0. 77. These biomarkers improved the classification of the clinical pulmonary infection score when combined. Concentration of TNFRI and PAI-1 and the slope of PAI-1 and IL-10 may be used to predict the development of VAP as early as 3 days before the diagnosis made clinically. TNFRI and GCSF may be used to exclude VAP at the moment of clinical suspicion. Especially TNFRI seems to be a promising marker for the prediction and diagnosis of VAP. The online version of this article (doi:10. 1186/s40635-015-0062-1) contains supplementary material, which is available to authorized users.
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan aquestes es distribueixin sota la mateixa llicència que regula l'obra original i es reconegui l'autoria de l'obra original. Creative Commons
Llengua: Anglès
Document: Article ; recerca ; Versió publicada
Publicat a: Intensive Care Medicine Experimental, Vol. 3 (september 2015) , ISSN 2197-425X

DOI: 10.1186/s40635-015-0062-1
PMID: 26377207


11 p, 700.3 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
Articles > Articles de recerca
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 Registre creat el 2018-01-31, darrera modificació el 2024-02-29



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