Diagnostic and Prognostic Value of Neopterin Levels in Serum and Bronchoalveolar Lavage Fluid in Sepsis

Abstract

INTRODUCTION: This study aimed to measure NT levels in serum and BAL fluid to determine the diagnostic and prognostic value of NT in sepsis. METHODS: This descriptive, cross-sectional study included intensive care patients over the age of 18 who underwent IMV and blood and BAL sampling at admission. Forty-five patients were analyzed retrospectively as those with sepsis and without sepsis RESULTS: Serum and BAL NT concentrations were statistically significantly higher in patients with sepsis. The diagnostic power of serum and BAL NT were 85.8% and 76.1%, respectively. Serum NT and CRP were found as independent risk factors for sepsis. Using these two biomarkers together yielded a diagnostic value of 93.3%. BAL NT correlated with CPIS. Serum NT level was significantly higher in sepsis patients who developed septic shock than in those who did not. DISCUSSION AND CONCLUSION: Serum NT had comparable diagnostic value in sepsis to the widely used biomarker, procalcitonin. Combined use with CRP increases the diagnostic value, specificity, and sensitivity of serum NT in sepsis. Serum NT can also be used as a prognostic indicator and may be predictive of the rapidly developing processes that lead to shock. Despite the lower value of BAL NT for the diagnosis of sepsis, its correlation with clinical pulmonary infection score suggests that it may indicate disease severity in ventilator-associated pneumonia.

Keywords

• neopterin
• bronchoalveolar lavage
• sepsis
• biomarker