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Soluble urokinase plasminogen activator receptor for the prediction of ventilator-associated pneumonia

2019-02-01Artigo científico Acesso aberto
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dc.contributor.authorVan Oort, Pouline M.
dc.contributor.authorBos, Lieuwe D.
dc.contributor.authorPóvoa, Pedro
dc.contributor.authorPovoa, Pedro
dc.contributor.authorRamirez, Paula
dc.contributor.authorTorres, Antoni
dc.contributor.authorArtigas, Antonio
dc.contributor.authorSchultz, Marcus J.
dc.contributor.authorMartin-Loeches, Ignacio
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblEuropean Respiratory Society
dc.date.accessioned2019-06-03T22:08:35Z
dc.date.available2019-06-03T22:08:35Z
dc.date.issued2019-02-01
dc.description.abstractIntroduction: Diagnosing ventilator-associated pneumonia (VAP) remains challenging. Soluble urokinase plasminogen activator receptor (suPAR) has prognostic value in critically ill patients with systemic infection. We hypothesised that plasma suPAR levels accurately predict development of VAP. Methods: This observational, multicentre, prospective cohort study compared patients at risk for VAP with a control group. Plasma and tracheal aspirate samples were collected. Plasma suPAR levels were measured on the day of diagnosis and 3 days before diagnosis. Results: The study included 24 VAP patients and 19 control patients. The suPAR concentration measured 3 days before diagnosis was significantly increased in VAP patients versus matched samples of control patients (area under the receiver operating characteristic curve (AUC) 0.68, 95% CI 0.52-1.00; p=0.04). Similar results were found on the day of diagnosis (AUC 0.77, 95% CI 0.6-0.93; p=0.01). Plasma suPAR was significantly higher in deceased patients (AUC 0.79, 95% CI 0.57-1.00; p<0.001). Combining suPAR with the Clinical Pulmonary Infection Score, C-reactive protein and/or procalcitonin led to a significantly increased discriminative accuracy for predicting VAP and an increased specificity. Conclusions: suPAR can be used to diagnose VAP with a fair diagnostic accuracy and has a moderate prognostic accuracy to be used in critically ill intensive care unit patients. Its performance improves when added to other clinically available biomarkers (C-reactive protein and procalcitonin) or scoring systems (Clinical Pulmonary Infection Score and Sepsis-related Organ Failure Assessment).en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent734296
dc.identifier.doi10.1183/23120541.00212-2018
dc.identifier.issn2312-508X
dc.identifier.otherPURE: 13579871
dc.identifier.otherPURE UUID: 3b3e1621-8eb7-4dc3-9cb7-3c5a91f3f1db
dc.identifier.otherPubMed: 30918897
dc.identifier.otherPubMedCentral: PMC6431752
dc.identifier.otherWOS: 000532535900037
dc.identifier.otherScopus: 85087366741
dc.identifier.urihttp://www.scopus.com/inward/record.url?scp=85065992221&partnerID=8YFLogxK
dc.identifier.urlhttps://www.scopus.com/pages/publications/85065992221
dc.language.isoeng
dc.peerreviewedyes
dc.subjectCRITICALLY-ILL PATIENTS
dc.subjectBIOLOGICAL MARKER
dc.subjectSUPAR
dc.subjectPROCALCITONIN
dc.subjectMORTALITY
dc.subjectDIAGNOSIS
dc.subjectSEVERITY
dc.subjectBIOMARKER
dc.subjectSEPSIS
dc.subjectSCORE
dc.subjectPulmonary and Respiratory Medicine
dc.titleSoluble urokinase plasminogen activator receptor for the prediction of ventilator-associated pneumoniaen
dc.typejournal article
degois.publication.issue1
degois.publication.titleERS Monograph
degois.publication.volume5
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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