Serial Changes in sTREM-1 During Ventilator-associated Pneumonia (VAP) - Full Text View

Purpose

Triggering receptor expressed on myeloid cells (TREM)-1 is a recently described molecule that plays an important role in myeloid cell-activated inflammatory responses. The aim of this study was to investigate the evolutional change of soluble TREM-1 (sTREM-1) in bronchoalveolar lavage (BAL) fluid of clinically diagnosed ventilator-associated pneumonia (VAP) and its correlation with response to treatment and outcome.

Condition	Intervention
Pneumonia	Procedure: Bronchoscopy BAL

Study Type:	Observational
Study Design:	Observational Model: Case-Only Time Perspective: Prospective
Official Title:	Serial Changes of Soluble TREM-1 Level in Bronchoalveolar Lavage Fluid During Ventilator-associated Pneumonia

Resource links provided by NLM:

MedlinePlus related topics: Pneumonia

U.S. FDA Resources

Further study details as provided by Mackay Memorial Hospital:

Primary Outcome Measures:

mortality [ Time Frame: 18 months ] [ Designated as safety issue: No ]

Enrollment:	35
Study Start Date:	August 2006
Study Completion Date:	September 2008
Primary Completion Date:	December 2007 (Final data collection date for primary outcome measure)

Groups/Cohorts	Assigned Interventions
Ventilator-associated pneumonia	Procedure: Bronchoscopy BAL The bronchoscope was passed through endotracheal tube via a specific adaptor without topical anesthesia. The bronchoscope was introduced and wedged into the segmental bronchial orifice where pneumonia was suspected. Five aliquots of 20ml sterile saline were instilled and aspirated gently. The first aliquot was discarded and the last 4 aliquots were pooled for analysis. Part of the retrieved specimen in the first BAL fluid was sent to the laboratory immediately after collection for measurement of sTREM-1 level, the rest of sample was sent to microbiology lab for quantitative culture.

Groups/Cohorts

Assigned Interventions

Ventilator-associated pneumonia

Procedure: Bronchoscopy BAL

The bronchoscope was passed through endotracheal tube via a specific adaptor without topical anesthesia. The bronchoscope was introduced and wedged into the segmental bronchial orifice where pneumonia was suspected. Five aliquots of 20ml sterile saline were instilled and aspirated gently. The first aliquot was discarded and the last 4 aliquots were pooled for analysis. Part of the retrieved specimen in the first BAL fluid was sent to the laboratory immediately after collection for measurement of sTREM-1 level, the rest of sample was sent to microbiology lab for quantitative culture.

Detailed Description:

A prospective, interventional study conducted between August 2006 and August 2007 in MICU in Mackay Memorial Hospital, 35 patients with clinically diagnosed VAP were investigated. sTREM-1 was measured in BAL samples using ELISA at the onset, 4th - 5th and 7th - 9th day of clinical diagnosis of VAP.Of these 35 patients, 27 had positive BAL culture. The sTREM-1 levels in BAL fluid were measured and compared between patients with positive BAL culture and negative BAL culture. Serial changes in sTREM-1 levels were evaluated in relation to patient outcome.

Eligibility

Ages Eligible for Study:	18 Years to 86 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No
Sampling Method:	Non-Probability Sample

Study Population

Patients who were clinically suspected to have VAP were enrolled in the study. VAP was clinically diagnosed with a new infiltrate on a chest radiograph in a patient receiving mechanical ventilation for more than 48 hr with at least one of the following: purulent tracheal secretions, a body temperature >38°C or <36°C, and leukocytosis (WBC > 10,000/mm³) or leukopenia (WBC < 4000/mm³)

Criteria

Inclusion Criteria:

adult patients (older than 18 years)with clinically suspected VAP

Exclusion Criteria:

mechanically ventilated patients post cardiopulmonary resuscitation
patients with end stage diseases with life expectancy less than 3 months
patients with solid or hematology transplantation
patients on immunosuppressive agents

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00976157

Locations

Taiwan
Mackay Memorial Hospital
Taipei, Taiwan, 106

Sponsors and Collaborators

Mackay Memorial Hospital

Investigators

Principal Investigator:

Chien Liang Wu, MD

Mackay Memorial Hospital, Taipei, Taiwan

More Information

Additional Information:

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This link exits the ClinicalTrials.gov site

No publications provided

Responsible Party:	Cheng-Ho Tsai,superintendent, Mackay Memorial Hospital
ClinicalTrials.gov Identifier:	NCT00976157 History of Changes
Other Study ID Numbers:	MMH-I-S-201
Study First Received:	September 11, 2009
Last Updated:	September 14, 2009
Health Authority:	Taiwan: Department of Health

Keywords provided by Mackay Memorial Hospital:

STREM-1
BAL
VAP

Additional relevant MeSH terms:

Pneumonia
Pneumonia, Ventilator-Associated
Lung Diseases
Respiratory Tract Diseases
Respiratory Tract Infections

Cross Infection
Infection
Ventilator-Induced Lung Injury
Lung Injury

ClinicalTrials.gov processed this record on May 16, 2013