Journal article
Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in BAL fluid of patients with pulmonary infiltrates in the ICU
Chest, Vol.135(3), pp.641-647
03/2009
DOI: 10.1378/chest.08-1829
PMID: 18849395
Abstract
Prospective single-center study to determine whether the presence of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) has diagnostic utility in patients with pulmonary infiltrates receiving mechanical ventilation and undergoing BAL.
Prospective cohort study.
Barnes-Jewish Hospital, a 1,200-bed urban teaching hospital.
Adult patients with acute respiratory failure undergoing BAL for pulmonary infiltrates.
BAL fluid measurement of sTREM-1 concentration using a Quantikine Human TREM-1 Immunoassay (R&D Systems; Minneapolis, MN).
A total of 105 consecutive patients receiving mechanical ventilation and undergoing BAL were enrolled. Of those, 19 patients (18.1%) met definite microbiologic criteria for bacterial or fungal ventilator-associated pneumonia (VAP). Though the mean sTREM-1 concentration was greater in patients with definite VAP (n = 19; 171.9 +/- 158.7 pg/mL) than in patients with definite absence of VAP (n = 21; 96.7 +/- 76.2 pg/mL), this difference was not statistically significant (p = 0.06). A cutoff value for sTREM-1 > 200 pg/mL yielded a diagnostic sensitivity of 42.1% and a specificity of 75.6% for definite VAP. Patients with alveolar hemorrhage had the greatest values for sTREM-1 concentration (n = 9; 555 +/- 440 pg/mL). Receiver operating curve analysis and multivariate logistic regression analysis demonstrated that measurement of sTREM-1 was inferior to clinical parameters for the diagnosis of VAP.
Measurement of sTREM-1 in BAL fluid appears to have minimal diagnostic value for VAP.
Details
- Title: Subtitle
- Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in BAL fluid of patients with pulmonary infiltrates in the ICU
- Creators
- Nitin J Anand - Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MOScott Zuick - Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MOJulia Klesney-Tait - Division of Pulmonary, Occupational Medicine, and Critical Care, University of Iowa Hospitals and Clinics, Iowa City, IAMarin H Kollef - Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO. Electronic address: mkollef@im.wustl.edu
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.135(3), pp.641-647
- DOI
- 10.1378/chest.08-1829
- PMID
- 18849395
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Language
- English
- Date published
- 03/2009
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984094614502771
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