Use of Reticulocyte Ratio and Neutrophil / Lymphocyte Ratio in the Diagnosis of Ventilator-associated Pneumonia

In this study, the utility of changes in the ratio of Ret-He and NLR as an early inflammation marker for VAP will be evaluated.

Study Overview

• Status: Completed
• Conditions: Ventilator-associated Pneumonia (VAP)
• Intervention / Treatment: Diagnostic test: reticulocyte/hemoglobin (Ret-He) ratio

Detailed Description

Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in the intensive care unit, affecting one third of patients requiring mechanical ventilation for a noninfectious reason. In the case of inflammation, iron retention increases in the reticuloendothelial system cells; hemoglobin (Hb) synthesis is reduced. It has been reported that the ratio of reticulocyte / hemoglobin (Ret-He) decreases in the early period in community-acquired pneumonia patients and may be a guide as a marker of inflammation. In addition, the neutrophil / lymphocyte ratio (NLR) is a parameter studied in the hemogram panel. It provides a clue to both the presence of infection and the focus of the infection.

In this study, the utility of changes in the ratio of Ret-He and NLR as an early inflammation marker for VAP will be evaluated.

• Study Type: Observational
• Enrollment (Actual): 35

Contacts and Locations

Study Locations

• Turkey
  • Kötekli
    • Muğla, Kötekli, Turkey, 48000
      • Mugla Sitki Kocman Universty

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: N/A

• Sampling Method: Probability Sample

Study Population

Patients who need mechanical ventilation for longer than 48 hours for a noninfectious reason in the intensive care unit

Description

Inclusion Criteria:

-Patients who need mechanical ventilation for longer than 48 hours for a noninfectious reason in the intensive care unit

Exclusion Criteria:

• Pulmonary or extrapulmonary infection before mechanical ventilation,
• severe immunosuppression,
• bleeding in the gastrointestinal system,
• using corticosteroids,
• neoplastic disease history

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

ventilator-associated pneumonia; Ret-He values will be studied on the day (1st day), 4th and 7th days of VID diagnosis in patients receiving mechanical ventilation support in the intensive care unit. The hemogram, CRP, and NLR values that are routinely studied in the intensive care unit will be recorded. In addition, in case of infection, the routinely studied procalcitonin value will also be recorded. The patient's age, gender, APACHE II, SOFA scores will be recorded; respiratory system examination, fever, the mental status evaluation will be done daily.

Diagnostic test: reticulocyte/hemoglobin (Ret-He) ratio; Ret-He values will be studied on the day (1st day), 4th and 7th days of the diagnosis of ventilator-associated pneumonia in patients hospitalized in the intensive care unit.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Early inflammation markers for VAP	To investigate the use of NLR and Ret-He value as early inflammation markers for VAP.	7 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
morbidity and mortality	To compare the effects of Ret-He and NLR values on morbidity and mortality with other inflammation markers	7 days

Collaborators and Investigators

• Sponsor: Muğla Sıtkı Koçman University
• Investigators: Study Chair: turhan togan, Mugla Sitki Kocman Universty Department of Infection Disease; Study Chair: Canan Gursoy, Mugla Sitki Kocma University Department of Intensive Care; Study Chair: Semra Demirbilek, Mugla Sitki Kocman Universty Department of Anesthesia

Study record dates

Study Major Dates

• Study Start (Actual): February 21, 2022
• Primary Completion (Actual): September 21, 2023
• Study Completion (Actual): December 21, 2023

Study Registration Dates

• First Submitted: November 3, 2020
• First Submitted That Met QC Criteria: November 3, 2020
• First Posted (Actual): November 9, 2020

Study Record Updates

• Last Update Posted (Actual): November 6, 2024
• Last Update Submitted That Met QC Criteria: November 4, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: Ventilator-associated pneumonia; reticulocyte/hemoglobin ratio; neutrophil/lymphocyte ratio
• Additional Relevant MeSH Terms: Healthcare-Associated Pneumonia; Pathologic Processes; Disease Attributes; Respiratory Tract Infections; Infections; Respiratory Tract Diseases; Lung Diseases; Cross Infection; Iatrogenic Disease; Pneumonia; Pneumonia, Ventilator-Associated; Physiological Effects of Drugs; Anti-Inflammatory Agents; Peripheral Nervous System Agents; Antirheumatic Agents; Sensory System Agents; Analgesics, Non-Narcotic; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Chrysarobin
• Other Study ID Numbers: 27/12/2019-19/XI

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No