Diagnostic Performance of Soluble Triggering Receptor Expressed on Myeloid Cells-1 in Ventilator-Associated Pneumonia of Patients with Ischemic Stroke.
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 (≥104cfu/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.
Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.
Yuetian
Y
Yu
Department of Emergency Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
Cheng
0000-0002-0846-6740
C
Zhu
Department of Emergency Medicine, Minhang Central Hospital, School of Medicine, Fudan University, Shanghai 201100, China.
Chunyan
C
Liu
Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.
Yuan
0000-0001-8271-2914
Y
Gao
Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.
Rong
0000-0003-0987-847X
R
Yin
Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.
Jianguo
0000-0002-7364-5892
J
Cao