Critical Care/Respiratory CareNew Biological Markers of Ventilator-Associated PneumoniaRamirez, Paula MD*; Menendez, Rosario MD, PhD†; Torres, Antoni MD, PhD‡Author Information From *Unidad de Cuidados Intensivas, Hospital Universitaria la Fe, Valencia; †Servicía de Neumologia, Hospital Universitario la Fe, Valencia; and ‡ Servei de Pneumologia, Institut Clinic de Pneumologia I Cirugia, Toracica, Hospital Clinic, Barcelona, Spain. Address correspondence to: Paula Ramirez, MD, Hospital Universitario la Fe, Intensive Care Unit, Avenida Campanar 21 E-46009 Valencia, Spain. E-mail: [email protected]. Clinical Pulmonary Medicine: March 2007 - Volume 14 - Issue 2 - p 93-98 doi: 10.1097/01.cpm.0000257584.73243.8d Buy Metrics AbstractIn Brief The signs and symptoms indicating the possible presence of ventilator-associated pneumonia (VAP) have a low specificity and sensitivity. Moreover, microbiological confirmation may be delayed up to 3 days and influenced by the previous use of antibiotics. However, VAP is one of the most frequent infectious complications in patients admitted to intensive care units and it is, therefore, necessary to improve the diagnostic arsenal for this infection. Consequently, there have been attempts to use biological markers in the diagnosis of VAP; the ideal substance would be one with correct sensitivity and specificity that could also be analyzed quickly and at a moderate cost. The previously used biological markers have not been, for different reasons, converted into a commonly used technique in clinical practice. Currently, the products derived from the inflammatory response, whether local or systemic, are being widely studied. Serum C-reactive protein (CRP) is a widely used technique of low economic cost but easily influenced by other inflammatory circumstances. Serum procalcitonin may be a good marker of VAP, but further studies are required to corroborate this quite economically viable technique. Although promising, the clinical use of s-TREM needs more evidence. Despite the increasing number of studies using cytokines in VAP, results are discordant. Clinical and microbiological diagnosis of ventilator-associated pneumonia remains difficult for several reasons. Biological markers can be used as an early and accurate diagnostic tool for ventilator-associated pneumonia. Procalcitonin and soluble triggering receptor expressed on myeloid cells seem to be the most promising biomarkers. © 2007 Lippincott Williams & Wilkins, Inc.