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Respirology. 2011 Apr;16(3):487-94. doi: 10.1111/j.1440-1843.2011.01945.x.

Prognostic value of dynamic soluble triggering receptor expressed on myeloid cells in bronchoalveolar lavage fluid of patients with ventilator-associated pneumonia.

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1
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan. wuchienliang100@pchome.com.tw

Abstract

BACKGROUND AND OBJECTIVE:

The aim of this study was to investigate the time course, and correlation with prognosis, of BAL fluid concentrations of soluble triggering receptor expressed on myeloid cells (sTREM-1) in patients with ventilator-associated pneumonia (VAP).

METHODS:

The study included 35 patients with clinically diagnosed VAP, eight of whom were BAL fluid culture-negative and 27 BAL fluid culture-positive (16 survivors, 11 non-survivors). sTREM-1 levels were measured in BAL fluid of these mechanically ventilated patients, at the time of diagnosis, on days 4-5 and on days 7-9. The time course of this biomarker and its prognostic value for outcome in patients with culture-positive VAP were assessed.

RESULTS:

sTREM-1 concentrations were significantly greater in culture-positive VAP patients than in culture-negative VAP patients. sTREM-1 levels decreased significantly with time in surviving patients with culture-positive VAP, but increased significantly with time in non-survivors. In contrast, PaO(2)/fraction of inspired oxygen (FiO(2)) increased significantly with time in survivors and decreased significantly with time in non-survivors. At a cut-off value of -10 pg/mL 7-9 days after initial diagnosis, sTREM levels had a sensitivity of 90% and a specificity of 87.5% for predicting mortality.

CONCLUSIONS:

sTREM-1 concentrations in BAL fluid are of potential prognostic value in patients with VAP.

[Indexed for MEDLINE]

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