2009 Round 2 - AAGBI/Anaesthesia Small Research Grant

Dr Vimal Grover

Clinical Fellow in Intensive Care Medicine & Anaesthetics SpR (Imperial School) Chelsea and Westminster Hospital

The use of soluble and surface TREM-1 (Triggering Receptor Expressed on Myeloid cells) as a marker of Ventilator Associated Pneumonia (VAP) in Intensive Care

Summary: Our study sought to speed up the diagnosis of VAP and differentiate it from non-pulmonary infection by measurement of an immune protein (TREM-1) in bronchoalveolar lavage (BAL) fluid and blood. TREM-1 levels were measured on CD14 positive monocytes in ventilated patients with VAP and non-pulmonary sepsis as well as ventilated and non-ventilated non-infected controls.

BAL monocytic surface TREM-1 increased in VAP. The BAL/blood ratio increased discrimination further between the groups and differentiated sites of infection. A biomarker panel incorporating this ratio and other proteins showed promise in diagnosing VAP.