Low Alveolar Macrophages Function, Low Balf IL-6 Level and High Balf CD4 Cell Count Is Associated with Successful Extubation and Survival in Severe Pneumonia Patients

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Abstract

Background: To assess Bronchoalveolar-Lavage Fluid (BALF) biomarker inter-relationship of severely affected lung and their association in determining successful extubation and survival. Methods: This prospective cohort study enrolled one hundred thirty-seven hospitalized severe pneumonia patients admitted to the Resuscitation Emergency Unit/Intensive Care Unit (REU/ICU) of Cipto Mangunkusumo Hospital, Indonesia from November 2020 – January 2021. Inclusion criteria: aged 18 years or older; severe pneumonia (IDSA/ATS 2007 criteria); can undergo bronchoscopy within 12 hours of admission to REU/ICU; receive empirical antibiotics of no more than 24 hours; and intubated within 24 hours. Exclusion criteria: acute respiratory distress syndrome (ARDS) non-infection; HIV/AIDS (confirmed by rapid anti-HIV testing); active malignancy within the last 12 months; on immunosuppressant therapy; refused to undergo bronchoscopy. Univariate analysis was performed for subject characteristics and bivariate analysis was performed for BALF biomarkers (sTREM, alveolar macrophages, IL-6, IL-17, CD4, Treg Foxp3+, SP-A and caspase-3). All p values <.05 were considered statistically significant.
Original languageEnglish
JournalIndonesian Journal Chest & Critical Care Medicine
Volume11
Issue number1
Publication statusPublished - 2024

Keywords

  • Successful extubation
  • alveolar macrophages
  • IL-6
  • CD4
  • severe pneumonia

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