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Table 7 Studies evaluating the value of biomarkers in diagnosing VAP

From: Diagnosis of ventilator-associated pneumonia: a systematic review of the literature

First author

Sample

Dx Tests

Gold standard

Results

Povoa, 2005, # [73]

Mixed ICU, 112 pts

CRP

Johanson

CRP (>9.6 mg/dl): sens = 87%, spec = 88%, AUC = 0.92.

Gibot, 2004, ** [75]

Mixed ICU, 148 pts

sTREM-1 in mini-BAL

Mini-BAL (103) Clinical (ad hoc)

Sens = 98%, spec = 90%.

Duflo, 2002, ** [71]

Mixed ICU, 96 pts

PCT serum & alveolar

Mini-BAL (103)

Serum PCT (≥3.9 ng/ml): sens = 41%, spec = 100%, AUC = 0787.

Alveolar PCT: not useful.

Oppert, 2002, ** [72]

Mixed ICU, 28 pts

PCT and PCR

Clinical (ad hoc)

Serum PCT (>1 ng/ml): sens = 100%, spec = 75%.

El-Ebiary, 1995, *, ** [69]

Mixed ICU, 78 pts

Elastin fibre

Clinical (ad hoc)

EF: sens = 32%, spec = 72%.

Determann, 2005, ** [76]

Mixed ICU, 28 pts

sTREM-1

Clinical & NBLF

Sens = 75%, spec = 84%.

Pugin, 1992, ** [78]

Trauma ICU, 40 pts

BAL Endotoxin

Clinical & BAL

BAL endotoxin > 6 EU/ml suggests pneumonia due to Gram-negative bacteria.

Flanagan, 2001, ** [77]

Mixed ICU, 64 pts

BAL Endotoxin

Clinical & BAL

Sens = 81%, spec = 87%, PPV = 67%, NPV = 95%.

  1. AUC: area under the curve; ICU = intensive care unit; CRP = C-reactive protein; sens = sensitivity; spec = specificity; sTREM-1 = soluble triggering receptor expressed on myeloid cells; BAL = bronchoalveolar lavage; PCT = procalcitonin; EF = elastin fiber; NBLF = non-directed bronchial lavage fluids; EU = endotoxin units; *retrospective; **consecutive; #convenient.