EP347 - THE ROLE OF BIOMARKERS IN DIAGNOSTIC APPROACHES IN NEONATES AND CHILDREN SUFFERING FROM VENTILATOR-ASSOCIATED PNEUMONIA (VAP) (ID 1475)
Abstract
Backgrounds:
Ventilator-associated pneumonia (VAP) is considered to be one of the most common nosocomial infections, especially among Pediatric and Neonatal ICU patients, and has been related to increased morbidity, length of stay and antibiotic usage. Nevertheless, the diagnostic approach of VAP remains debatable. The aim of this study is to evaluate the role of biomarkers in the diagnosis of VAP in critically ill children.
Methods
A systematic review of English language studies was conducted in order to investigate the diagnostic role of biomarkers in VAP. The electronic databases of Medline and EMBASE were searched until December 2021. The terms used to conduct the search included “biomarkers” and “VAP”. Data extraction and synthesis followed a standardized format on Covidence. All publication records were independently reviewed by two authors and disagreements were resolved by consensus. Inclusion criteria were: studies reporting data only for neonates and children for the diagnosis of VAP.
Results:
Overall, 318 studies were found; among them, a total of 33 articles met inclusion criteria and were analyzed. Diagnostic modalities for VAP included CDC criteria and Clinical Pulmonary Infection Score (CPIS). New biomarkers for the diagnosis of VAP included mainly Soluble Triggering Receptor Expressed on Myeloid cells (S-TREM-1) and Surfactant protein D (SPD) in bronchoalveolar lavage (BAL). Increased concentrations of S-TREM-1 in BAL showed 96% sensitivity and 92% specificity in one of the included studies. Similarly, high SPD concentrations in BAL correlated well diagnosing suspected VAP among pediatric patients.
Conclusions/Learning Points:
S-TREM-1 and SPD may play a vital role regarding diagnosis of suspected VAP in critically ill children. However, there is a great need for conducting large cohort studies in neonatal and pediatric patients to consolidate diagnostic utility of S-TREM-1 and SPD for VAP diagnosis.
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