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Báo cáo y học: "Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in patients with acute respiratory distress syndrome and abdominal diseases: a preliminary observational study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in patients with acute respiratory distress syndrome and abdominal diseases: a preliminary observational study. | Ramirez et al. Critical Care 2011 15 R50 http ccforum.eom content 15 1 R50 KS CRITICAL CARE RESEARCH Open Access Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in patients with acute respiratory distress syndrome and abdominal diseases a preliminary observational study 1 1 1 2 3 4 Paula Ramirez Pedro Kot Veronica Marti Maria Dolores Gomez Raquel Martinez Vicente Saiz Francisco Catala4 Juan Bonastre1 Rosario Menendez3 Abstract Introduction Patients admitted to the intensive care unit ICU because of acute or decompensated chronic abdominal disease and acute respiratory failure need to have the potential infection diagnosed as well as its site pulmonary or abdominal . For this purpose we measured soluble triggering receptor expression on myeloid cells-1 sTREM-1 in alveolar and peritoneal fluid. Methods Consecutive patients n 21 with acute or decompensated chronic abdominal disease and acute respiratory failure were included. sTREM was measured in alveolar A-sTREM and peritoneal P-sTREM fluids. Results An infection was diagnosed in all patients. Nine patients had a lung infection without abdominal infection 5 had an abdominal infection without lung infection and seven had both infections. A-sTREM was higher in the patients with pneumonia compared to those without pneumonia 1963 ng ml 1010-3129 vs. 862 ng ml 333-1011 P 0.019 . Patients with abdominal infection had an increase in the P-sTREM compared to patients without abdominal infection 1941 ng ml 1088-3370 vs. 305 ng ml 288-459 P 0.001 . A cut-off point of 900 pg ml of A-sTREM-1 had a sensitivity of 81 and a specificity of 80 NPV 57 PPV 93 AUC 0.775 for the diagnosis of pneumonia. In abdominal infections a cut-off point for P-sTREM of 900 pg ml had the best results sensitivity 92 specificity 100 NPV 90 PPV 100 AUC 0.903 . Conclusions sTREM-1 measured in alveolar and peritoneal fluids is useful in assessing pulmonary and peritoneal infection in critical-state patients-A-sTREM .