title: Prognostic value of dynamic soluble triggering receptor expressed on myeloid cells in bronchoalveolar lavage fluid of patients with ventilator-associated pneumonia.
abstract: 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.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan. wuchienliang100@pchome.com.tw
authors.forename: Chien-Liang
authors.initials: CL
authors.lastname: Wu
authors.forename: Yen-Ta
authors.initials: YT
authors.lastname: Lu
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Kung
authors.forename: Chao-Hsien
authors.initials: CH
authors.lastname: Lee
authors.forename: Ming-Jen
authors.initials: MJ
authors.lastname: Peng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D002318:Cardiovascular Diseases / Q000150:complications; D002561:Cerebrovascular Disorders / Q000150:complications; D062787:Drug Overdose / Q000150:complications; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis*; D008875:Middle Aged; D022423:Myeloid Cells / Q000378:metabolism*; D010100:Oxygen; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D011971:Receptors, Immunologic / Q000032:analysis*; D012680:Sensitivity and Specificity; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
chemical_list: D015415:Biomarkers; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D010100:Oxygen