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Tumor necrosis factor receptor 1 (TNFRI) for ventilator-associated pneumonia diagnosis by cytokine multiplex analysis

2015-12Artigo científico Acesso aberto
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dc.contributor.authorMartin-Loeches, Ignacio
dc.contributor.authorBos, Lieuwe D J
dc.contributor.authorPovoa, Pedro
dc.contributor.authorPovoa, Pedro
dc.contributor.authorRamirez, Paula
dc.contributor.authorSchultz, Marcus J.
dc.contributor.authorTorres, Antoni
dc.contributor.authorArtigas, Antonio
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionCentro de Estudos de Doenças Crónicas (CEDOC)
dc.contributor.pblSpringer
dc.date.accessioned2022-07-19T22:20:01Z
dc.date.available2022-07-19T22:20:01Z
dc.date.issued2015-12
dc.descriptionFunding: The authors acknowledged the support granted by the Instituto de Salud Carlos III (ISCIII) (ISCIII/FIS-PI 12/01815) Spanish Government
dc.description.abstractBACKGROUND: The diagnosis of ventilator-associated pneumonia (VAP) is challenging. An important aspect to improve outcome is early recognition of VAP and the initiation of the appropriate empirical treatment. We hypothesized that biological markers in plasma can rule out VAP at the moment of clinical suspicion and could rule in VAP before the diagnosis can be made clinically. METHODS: In this prospective study, patients with VAP (n = 24, microbiology confirmed) were compared to controls (n = 19) with a similar duration of mechanical ventilation. Blood samples from the day of VAP diagnosis and 1 and 3 days before were analyzed with a multiplex array for markers of inflammation, coagulation, and apoptosis. The best biomarker combination was selected and the diagnostic accuracy was given by the area under the receiver operating characteristic curve (ROC-AUC). RESULTS: TNF-receptor 1 (TNFRI) and granulocyte colony-stimulating factor (GCSF) were selected as optimal biomarkers at the day of VAP diagnosis, which resulted in a ROC-AUC of 0.96, with excellent sensitivity. Three days before the diagnosis TNFRI and plasminogen activator inhibitor-1 (PAI-1) levels in plasma predicted VAP with a ROC-AUC of 0.79. The slope of IL-10 and PAI-1 resulted in a ROC-AUC of 0.77. These biomarkers improved the classification of the clinical pulmonary infection score when combined. CONCLUSIONS: Concentration of TNFRI and PAI-1 and the slope of PAI-1 and IL-10 may be used to predict the development of VAP as early as 3 days before the diagnosis made clinically. TNFRI and GCSF may be used to exclude VAP at the moment of clinical suspicion. Especially TNFRI seems to be a promising marker for the prediction and diagnosis of VAP.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent717110
dc.identifier.doi10.1186/s40635-015-0062-1
dc.identifier.issn0342-4642
dc.identifier.otherPURE: 2433909
dc.identifier.otherPURE UUID: 1289df20-8df7-43f3-bc02-6da9380327ff
dc.identifier.otherPubMed: 26377207
dc.identifier.otherPubMedCentral: PMC4572048
dc.identifier.otherScopus: 85008158046
dc.identifier.urihttp://hdl.handle.net/10362/142143
dc.language.isoeng
dc.peerreviewedyes
dc.subjectPromising Marker
dc.subjectClinical Pulmonary Infection Score
dc.subjectIntegrate Discrimination Improvement
dc.subjectPneumonia Diagnosis
dc.subjectMultiplex Array
dc.titleTumor necrosis factor receptor 1 (TNFRI) for ventilator-associated pneumonia diagnosis by cytokine multiplex analysisen
dc.typejournal article
degois.publication.firstPage
degois.publication.issue1
degois.publication.lastPage
degois.publication.titleIntensive Care Medicine
degois.publication.volume3
dspace.entity.typePublication
person.familyNamePovoa
person.givenNamePedro
person.identifier.ciencia-id0C16-5CF9-9238
person.identifier.orcid0000-0002-7069-7304
person.identifier.scopus-author-id6602772147
rcaap.rightsopenAccess
relation.isAuthorOfPublication04ec38ba-be1e-46e5-8007-0e65a557d0f4
relation.isAuthorOfPublication.latestForDiscovery04ec38ba-be1e-46e5-8007-0e65a557d0f4

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