title: Could soluble urokinase plasminogen receptor (suPAR) be used as a diagnostic biomarker for ventilator-associated pneumonia?
abstract: BACKGROUND
  Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker that is increasingly used for evaluation of systemic inflammation. This study was performed to investigate whether suPAR may possess a diagnostic value in patients with ventilator-associated pneumonia (VAP).
  
  
  METHODS
  This clinical study was performed in the anesthesia intensive care units (ICUs) of our university. In addition to descriptive data, WBC, serum levels of C-reactive protein (CRP) and suPAR prior to and after development of VAP were noted and compared in 31 patients (22 men, 9 women) diagnosed with VAP (Study Group) and 19 patients without VAP (Control Group) in ICU (14 men, 5 women).
  
  
  RESULTS
  The suPAR (P = 0.023), CRP (P = 0.037), WBCs (P = 0.024) in patients with VAP were significantly higher than patients without VAP. There was no remarkable difference in terms of WBCs (P = 0.052) and suPAR levels (P = 0.616) between groups on the first day of connection to mechanical ventilator. The suPAR and CRP levels in patients with VAP were significantly higher than prior to development of VAP (P = 0.001 for both). Area under curve value after diagnosis of pneumonia was found 0.248 (P = 0.002).
  
  
  CONCLUSIONS
  To conclude, our results suggest that suPAR can be a useful diagnostic biomarker in patients with VAP. However, clinical trials on larger series are warranted to explore the clinical significance more accurately.
authors.affiliation: Department of Chest Diseases, Yuzuncu Yil University Medical Faculty, Van, Turkey.
authors.forename: Aysel
authors.initials: A
authors.lastname: Sunnetcioglu
authors.affiliation: Department of Infectious Diseases, Yuzuncu Yil University Medical Faculty, Van, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Sunnetcioglu
authors.affiliation: Department of Infectious Diseases, Yuzuncu Yil University Medical Faculty, Van, Turkey.
authors.forename: Fırat
authors.initials: F
authors.lastname: Adıyaman
authors.affiliation: Department of Infectious Disease, Ercis State Hospital, Van, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Binici
authors.affiliation: Department of Anesthesiology and Intensive Care, Yuzuncu Yil University, Medical Faculty, Van, Turkey.
authors.forename: Lokman
authors.initials: L
authors.lastname: Soyoral
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D000066891:Critical Care Outcomes; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000150:complications / Q000175:diagnosis / Q000378:metabolism* / Q000382:microbiology; D011446:Prospective Studies; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D018805:Sepsis / Q000150:complications* / Q000382:microbiology / Q000401:mortality; D012122:Ventilators, Mechanical / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; D055293:Receptors, Urokinase Plasminogen Activator; D002097:C-Reactive Protein
keywords: C reactive protein; leukocyte count - ventilator-associated pneumonia; soluble urine plasminogen kinase activator