Prognostic value of cytokeratin 19 in bronchoalveolar lavage (BAL) in patients with acute lung injury (ALI)
J. B. Stern, C. Paugam, M. Dehoux, S. Jaffré, V. Leçon, J. Mantz, M. Aubier, B. Crestani (Paris, ; Paris, France)
Source: Annual Congress 2002 - Interstitial lung disease
Session: Interstitial lung disease
Session type: Assembly Symposium
Number: 3755
Abstract Background : Cytokeratin 19 (CK19), a specific cytoskeletal structure for simple epithelia, including bronchial and alveolar epithelial type 2 cells, has been used as a marker of lung epithelial damage. The aim of this study was to determine whether BAL CK19 concentration has a prognostic value in patients with ALI. Patients and methods: The study was conducted in an adult surgical ICU. BAL was performed in 22 patients mechanically ventilated with ALI/ARDS, 2.9 ±] 2.7 days after the lung insult (SAPSII : 35.0 ±] 9.4; PaO2/FIO2 :186 ±] 39, lung injury score (LIS) :1.92 ±] 0.7). 8 patients presented clinical and microbiological criteria of pneumonia. The mortality was recorded 30 days after the BAL procedure. BAL was also obtained from 10 non-ventilated patients (controls) without detectable pulmonary disease. CK19 was measured (ELISA) in non-concentrated BAL supernatant. Results: CK19 was detected in the BAL fluids from the 22 patients and the 10 controls. CK19 concentration was higher in patients (median 4916 pg/ml; 25th-75th:2717-10533) than in controls (2208 pg/ml ;767-3923, p=0.05). CK19 concentration did not correlate with SAPSII (r=0.1;p=0.5), LIS (r=-0.27; p=0.2) or PaO2/FIO2 ratio (r=0.17; p=0.4). CK19 concentration was not different in patients with pneumonia (6273 pg/ml; 2755-14508) and without pneumonia (median: 4260 pg/ml; 2015-7017, p=0.39). BAL fluid CK19 concentration was higher in 10 non survivors (median 7051 pg/ml; 4372-13371) than in 12 survivors (median 2888 pg/ml ; 1315-5639, p=0.03). Conclusion: BAL CK19 concentration is increased in patients with ALI. Elevated BAL CK19 is associated with a poor prognosis in patients with ALI.
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J. B. Stern, C. Paugam, M. Dehoux, S. Jaffré, V. Leçon, J. Mantz, M. Aubier, B. Crestani (Paris, ; Paris, France). Prognostic value of cytokeratin 19 in bronchoalveolar lavage (BAL) in patients with acute lung injury (ALI). Eur Respir J 2002; 20: Suppl. 38, 3755
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