ISSN (print) 1726-9806     ISSN (online) 1818-474X
No. 4 (2021), DIAGNOSTIC APPROACHES AND FORECASTING IN THE INTENSIVE CARE
No. 4 (2021)
DIAGNOSTIC APPROACHES AND FORECASTING IN THE INTENSIVE CARE

The prognostic value of changes in the plasma cytokine profile of neuroresuscitation patients with ventilator-associated pneumonia: two center observational study

Published 19.01.2022
Elizaveta P. Zinina
Federal Center of Treatment and Rehabilitation, Moscow, Russia
https://orcid.org/0000-0002-3257-6034
S.V. Tsarenko
City Clinical Hospital No 52, Moscow, Russia
https://orcid.org/0000-0002-7065-5331
D.Y. Logunov
N.F. Gamaleya Institute of Epidemiology and Microbiology, Moscow, Russia
https://orcid.org/0000-0003-4035-6581
A.I. Tukhvatulin
N.F. Gamaleya Institute of Epidemiology and Microbiology, Moscow, Russia
https://orcid.org/0000-0001-8506-2339
M.A. Magomedov
Pirogov City Clinical Hospital, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
https://orcid.org/0000-0002-1972-7336
A.V. Babayants
Pirogov Russian National Research Medical University, Moscow, Russia; S.S. Yudin City Clinical Hospital, Moscow, Russia; Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
https://orcid.org/0000-0003-3072-3237
A.A. Avramov
Federal Center of Treatment and Rehabilitation, Moscow, Russia
https://orcid.org/0000-0001-6055-3289
#2021-4
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Keywords

nosocomial pneumonia
ventilator-associated pneumonia
cytokines
matrix metalloproteinase-2

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1.
Zinina E.P., Tsarenko S.V., Logunov D.Y., Tukhvatulin A.I., Magomedov M.A., Babayants A.V., Avramov A.A. The prognostic value of changes in the plasma cytokine profile of neuroresuscitation patients with ventilator-associated pneumonia: two center observational study. Annals of Critical Care. 2022;(4):48-58. doi:10.21320/1818-474X-2021-4-48-58
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Abstract

Objectives. This study was performed to find changes in the plasma cytokine profile of neuroresuscitation patients with ventilator-associated pneumonia, and to search for prognostic markers of effectiveness of antibacterial treatment of ventilator-associated pneumonia. Materials and methods. A two-center clinical study, that included 73 patients aged 19 to 82 years with neurosurgical and neurological pathology and signs of ventilator-associated pneumonia (VAP) was conducted. On the 1st and 3rd days of antibiotic therapy, plasma samples were taken from patients, in which the concentration of 59 cytokines was determined. Retrospectively, patients were divided into groups of favorable and unfavorable clinical course of VAP. Predictors of the clinical course of the disease were identified using statistical methods, ROC analysis, and logistic regression. Results. Matrix metalloproteinase-2 (MMP-2) was the most sensitive predictor of the clinical outcomes of VAP in neuroresuscitation patients. In the group of patients with an unfavorable course of VAP, the concentration of MMP-2 in plasma was initially increased, but significantly decreased by the 3rd day, in contrast to the group with good outcomes. The logistic regression model predicted the clinical course of VAP with an accuracy of 69.2 %. Less sensitive but significant predictors of the clinical course of the disease were cytokines: interleukin-1 receptor antagonist, interleukin-6, granulocyte colony-stimulating factor, tumor necrosis factor superfamily member 14, osteocalcin, pentraxin, thymic stromal lymphopoietin, element 12 of the tumour necrosis factor ligand superfamily, and interleukin-12. Conclusions. Measurement of plasma cytokine levels is a prospective method to determine the effectiveness of antibacterial therapy in VAP. Matrix metalloproteinase-2 is a sensitive predictor of the clinical course of VAP in neuroresuscitation patients.

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