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Profiling inflammatory markers in patients with pneumonia on intensive care

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Title: Profiling inflammatory markers in patients with pneumonia on intensive care
Authors: Antcliffe, D
Wolfer, A
O'Dea, K
Takata, M
Holmes, E
Gordon, AC
Item Type: Journal Article
Abstract: Clinical investigations lack predictive value when diagnosing pneumonia, especially when patients are ventilated and develop ventilator associated pneumonia (VAP). New tools to aid diagnosis are important to improve outcomes. This pilot study examines the potential for a panel of inflammatory mediators to aid in the diagnosis. Forty-four ventilated patients, 17 with pneumonia and 27 with brain injuries, eight of whom developed VAP, were recruited. 51 inflammatory mediators, including cytokines and oxylipins, were measured in patients’ serum using flow cytometry and mass spectrometry. The mediators could separate patients admitted to ICU with pneumonia compared to brain injury with an area under the receiver operating characteristic curve (AUROC) 0.75 (0.61–0.90). Changes in inflammatory mediators were similar in both groups over the course of ICU stay with 5,6-dihydroxyeicosatrienoic and 8,9-dihydroxyeicosatrienoic acids increasing over time and interleukin-6 decreasing. However, brain injured patients who developed VAP maintained inflammatory profiles similar to those at admission. A multivariate model containing 5,6-dihydroxyeicosatrienoic acid, 8,9-dihydroxyeicosatrienoic acid, intercellular adhesion molecule-1, interleukin-6, and interleukin-8, could differentiate patients with VAP from brain injured patients without infection (AUROC 0.94 (0.80–1.00)). The use of a selected group of markers showed promise to aid the diagnosis of VAP especially when combined with clinical data.
Issue Date: 3-Oct-2018
Date of Acceptance: 18-Sep-2018
URI: http://hdl.handle.net/10044/1/64940
DOI: https://dx.doi.org/10.1038/s41598-018-32938-6
ISSN: 2045-2322
Publisher: Nature Publishing Group
Journal / Book Title: Scientific Reports
Volume: 8
Copyright Statement: © 2018 The Author(s). Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Sponsor/Funder: The Intensive Care Foundation
Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Intensive Care Society
Funder's Grant Number: N/A
IT150
RDB04 79560
RDB20
Keywords: Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
VENTILATOR-ASSOCIATED PNEUMONIA
BRONCHOALVEOLAR LAVAGE FLUID
CRITICALLY-ILL PATIENTS
ACQUIRED PNEUMONIA
DIAGNOSTIC-ACCURACY
MYELOID CELLS-1
STROKE
SEPSIS
VALIDATION
INFECTION
Publication Status: Published
Open Access location: https://rdcu.be/8oM1
Article Number: 14736
Appears in Collections:Division of Surgery
Faculty of Medicine



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