Clinical value of soluble triggering receptor expressed on myeloid cells-1 in early diagnosis and prognosis of ventilator-associated pneumonia

Objective This study examined the value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in serum and exhaled ventilator condensate(EVC)in early diagnosis and prognosis of ventilator-associated pneumonia(VAP).Methods A total of 37 adult patients undergoing mechanical ventilation were evaluated after treatment,including 24 patients with infection,13 without infection.Of the 24 patients with infection,10 patients were assigned to ineffective subgroup and 14to effective subgroup.Levels of sTREM-1in serum and EVC were measured on days 1,3,5,and 7 for all patients.sTREM-1 in serum and EVC were determined in patients by double antibody sandwich enzyme-linked immunosorbant assay(DASELISA).The early diagnostic and prognostic value was assessed by receiver operating characteristic(ROC)curve analysis.Results On Day 1,the sTREM-1 levels in serum and EVC did not show significant difference between the three groups(P0.05).On Day 3 and Day 5,the level of sTREM-1in the infection group was higher than that in the non-infection group(P0.01).On Day 7,the sTREM-1 levels of serum and EVC in ineffective subgroup were higher than those in the effective subgroup and non-infection group(P0.01).There were no difference between the non-infection group and effective subgroup(P0.05).For ROC analysis,area under the curve(AUC)of serum sTREM-1 was 0.897,and AUC of EVC sTREM-1 was 0.909 on Day 3.When the cut-off value of EVC sTREM-1 was set at 4.70 ng/mL on Day 3,the sensitivity was 85.8%,specificity was 92.3%.Conclusions The results suggest that the levels of sTREM-1 in serum and EVC are conducive to the early diagnosis of VAP.The levels of sTREM-1 in serum and EVC on Day 7 are helpful for estimating the prognosis.EVC sample is easier to collect than serum.