BRONCHOALVEOLAR LAVAGE UROKINASE AS A MARKER OF ACUTE RESPIRATORY DISTRESS SYNDROME

Abstract

T he present study aimed at estimation of active urokinase level in bronchoalveolar lavage fluid (BALF) using fiber-optic bronchoscope (FOB) in critically ill pediatric patients with ARDS and evaluation of its diagnostic value. The study started on June 2013 and was fulfilled on November 2014. The current study included 20 critically ill pediatric patients on mechanical ventilation with ARDS and 20 non-ARDS mechanically ventilated patients as control group, admitted to Ain-Shams PICU. In our study; the most common cause of ARDS was bronchopneumonia (75%). Moreover, urokinase activity in bronchoalveolar lavage was markedly depressed in patients with ARDS (Mean = 0.34 ng/ml urokinase activity in BALF) when compared to control group (Mean = 3.12 ng/ml urokinase activity in BALF) with (P-value <0.001 HS). There was no correlation between urokinase activity in BALF and any demographic or clinical parameters in patients and control groups. Moreover, we detected the best cut-off level for urokinase activity in BALF to diagnose ARDS in early exudative phase among ventilated patients as ≤ 1.05ng/ml with 95% sensitivity and 100% specificity.