Am J Med Public Health | Volume 4, Issue 5 | Research Article | Open Access
Saleh NY1*, El-din Habib MS2, Aboukoura MA1 and Garib MI1
1Department of Pediatrics, Menoufia University, Egypt
2Department of Medical Biochemistry and Molecular Biology, Menoufia University, Egypt
*Correspondance to: Nagwan Yossery Saleh
Fulltext PDFBackground: Granulocyte Colony Stimulating Factor (G-CSF) is a biomarker recommended for detection of Ventilator Associated Pneumonia (VAP). Purpose: To assess G-CSF level in mechanically ventilated children to determine its cut-off point for VAP diagnosis and mortality. Methods: A prospective research was performed on 122 children who were mechanically ventilated for more than 48 h at Pediatric Intensive Care Unit (PICU). All mechanical ventilated children were monitored for signs of VAP suspicion. 42 patients were without VAP suspicion and 80 suspected patients were subdivided regarding VAP confirmation by quantitative culture of non bronchoscopic Bronchoalveolar Lavage (BAL) into confirmed VAP (VAP group) and non-confirmed VAP group. Patients without VAP suspicion and non-confirmed VAP were considered as non-VAP control group. Clinical examination included estimation of Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality II (PIMII) and pediatric Sequential Organ Failure Assessment scores (pSOFA). Serum G-CSF was collected from the studied groups. The patients were monitored for 30 days. Results: G-CSF was significantly elevated in VAP group than non-VAP control group (P=0.001). Among VAP group, G-CSF was positively correlated with duration of PICU stay, Mechanical Ventilation (MV) duration, pSOFA, PRISM and PIMII scores. Through logistic regression analysis, there was significant association between G-CSF level, PICU stay, MV duration, pSOFA score, shock and VAP risk (OR=1.794, 1.955, 1.955, 1.673, 5.67 respectively). The cut-off point G-CSF was 886.8 ng/ml for diagnosing VAP, while cut-off point for C-reactive protein was 20 mg/dl. G-CSF cut-off point for mortality was 1630 ng/ml, while cut-off points for PRISM, PIM, and pSOFA scores were (6.00, 2.50, 8.50) correspondingly. Conclusion: High level of G-CSF is associated with VAP and its cut-off point can differentiate between confirmed VAP and non-confirmed VAP group.
Granulocyte colony stimulating factor; Pediatric; Ventilator associated pneumonia
Saleh NY, El-din Habib MS, Aboukoura MA, Garib MI. Value of Granulocyte Colony Stimulating Factor in Mechanically Ventilated Children for Ventilator Associated Pneumonia Diagnosis and Mortality. Am J Med Public Health. 2023; 4(5): 1055..