Precepsin: is it a new biomarker for the diagnosis and treatment management of ventilator-associated pneumonia?

With the introduction of the mechanical ventilator from the middle of the 20th century, the incidence of complications such as Ventilator-Associated Pneumonia has increased. The risk of developing Ventilator-Associated Pneumonia is higher in those exposed to invasive mechanical ventilation for a long time and is directly related to the length of stay in the ICU. It is stated that the incidence and mortality of ventilator-associated pneumonia is high. Difficulty in the diagnosis of Ventilator-Associated Pneumonia, the absence of a routinely applicable diagnostic method, and the fact that it takes a few days to detect bacteria from the sputum sample are among the main reasons for adverse clinical outcomes in the management of Ventilator-Associated Pneumonia. Today, it is recommended to use biomarkers to facilitate the diagnosis of Ventilator-Associated Pneumonia. Although there is no specific biomarker for this condition, the most frequently studied biological vehicles were procalcitonin (PCT), C-reactive protein (CRP), and myeloid cells type 1 (sTREM-1). An emerging infection biomarker is presepsin (PSP), which has recently been identified as an early marker of different infections. It is a fraction of the soluble form of the CD14 subtype of presepsin (sCD14-ST). The aim of this study is to demonstrate the usability of Presepsin in the diagnosis and follow-up of Ventilator-Associated Pneumonia. 42 patients and 30 healthy volunteers were included in this study. For the measurement of presepsin level, 2cc of blood was taken from the peripheral vein into a tube with EDTA (Ethylenediamine tetraacetic acid). Blood was drawn from the patient three times, on the day of diagnosis of Ventilator-Associated Pneumonia and on the 3rd and 7th days of the treatment, to study Presepsin level. IBM SPSS Statistics Version 22.0 package program was used in the statistical analysis of the data, and the result (p<0.05) was considered statistically significant in all analyzes. It was found to be statistically significant when compared with Procalcitonin at the time of diagnosis of presepsis. Although these results show that Presepsin is immediately significant in the diagnosis, we think that new multicenter studies are needed on this subject. Key Words: Ventilator-associated pneumonia, Presepsin, Intensive Care