Evaluation of the role of inflammatory biomarkers such as elabela, visfatin, chemerin and dynamic thiol / disulphide homeostasis in the diagnosis of ventilator-associated pneumonia

Objectives: Ventilator-associated pneumonia is one of the most common nosocomial infections in patients who hospitalized in the intensive care unit. VIP is the disease with the highest mortality rate among nosocomial infections. It causes a serious increase in morbidity and mortality of patients, prolongation of hospital stay and a serious cost burden. Laboratory parameters used in routine practice in the diagnosis of ventilator-associated pneumonia are parameters such as WBC, CRP and procalcitonin. Discovered in recent years; It is being studied whether new inflammatory biomarkers such as elabela, visfatin and chemerin are useful in the diagnosis, follow-up and prognosis of many disease groups. Our aim in this study is to reveal whether biomarkers such as elabela, visfatin and chemerin will be useful in the diagnosis of VAP. Materials And Methods: In our study, between 01.05.2021 and 01-10.2021, we were hospitalized in the 3rd step intensive care unit of Dicle University Medical Faculty Hospital and diagnosed as ventilator-associated pneumonia (this definition includes patients who have been on a mechanical ventilator for more than 2 days with radiologically newly developed pneumonic infiltrates, increased secretion and increased oxygen demand, and clinically diagnosed as pneumonia) patients were included. WBC, CRP and procalcitonin values were studied on the first day of VAP diagnosis, and on the 7th and 14th days afterwards, and blood samples were taken to study elabela, visfatin and chemerin parameters. Blood samples was taken from 30 healthy individuals for the control group. Elabela, visfatin and chemerin values measured on the 1st, 7th and 14th days were compared with the values detected in the control group as well as WBC, CRP and procalcitonin values. In addition, the 28-day survival rates of the patients were evaluated. Results: We found the chemerin values measured in VAP patients to be statistically significantly higher than the healthy control group (p=0.041). There was no statistically significant difference between the patient and control groups in terms of elabela and visfatin levels (p values 0.577 and 0.089, respectively). A statistically significant positive correlation was also determined between the chemerin values of the patients and the CRP and procalcitonin values (p values 0.033 and 0.001, respectively). No statistically significant correlation was found between the patients' elabela and visfatin levels and their WBC, CRP and procalcitonin levels. No significant correlation was found between Elabela, visfatin and Chemerin levels and 28-day mortality. The only biomarker that was found to be statistically significant in predicting 28-day mortality; was CRP (p=0.016) Conclusions: Chemerin, one of the biomarkers discovered in recent years, seems to be useful in diagnosing VAP. Elabela and visfatin levels, which are other biomarkers, have not been shown to be beneficial in the diagnosis of VAP. Chemerin seems to be significant in the diagnosis of VAP, but it was not found useful in predicting mortality in all three biomarkers. There is no other study in the literature regarding the place of these biomarkers in the diagnosis of VAP, and our findings are important in this respect. Keywords: Ventilator-associated pneumonia, elabela, visfatin, chemerin