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

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

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

Conditions
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Ventilator-associated Pneumonia (VAP)

Intervention / Treatment
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* Diagnostic Test: reticulocyte/hemoglobin (Ret-He) ratio


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ventilator-associated pneumonia<br>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<br>* 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.<br>|

What is the study measuring?
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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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ventilator-associated pneumonia, reticulocyte/hemoglobin ratio, neutrophil/lymphocyte ratio