The Utility of Neutrophil Gelatinase-Associated Lipocalin in the Detection of Emerging Lung Injury due to Mechanical Ventilation in Children: A Preliminary Study

OBJECTIVE: Lung injuries are mostly ignored in patients supported by mechanical ventilation. Neutrophil gelatinase-associated lipocalin has come into prominence as an early sensitive and highly predictive biomarker of inflammation. The purpose of the study was to assess the capability of neutrophil gelatinase-associated lipocalin in recognizing lung injuries in children requiring mechanical ventilation. MATERIALS AND METHODS: This prospective case-controlled study was carried out in a tertiary pediatric intensive care unit. The entire study group consisted of a total of 45 patients, 15 in the patient group (supported by invasive mechanical ventilation) and 30 in the control group (self-breathing). Whether lung injuries developed or not was investigated by measuring serum-neutrophil gelatinase-associated lipocalin and urine-neutrophil gelatinase-associated lipocalin levels in the course of ventilation support. RESULTS: In the patient group supported by mechanical ventilation, mean levels of serum-neutrophil gelatinase-associated lipocalin and urine-neutrophil gelatinase-associated lipocalin were measured as 192 ± 136.7 ng/mL and 43.7 ± 57.5 ng/mL, respectively. In the control group (self-breathing patients), mean levels of serum-neutrophil gelatinase-associated lipocalin and urine-neutrophil gelatinase-associated lipocalin were found as 144.8 ± 95 ng/mL and 39.3 ± 85 ng/mL, respectively. The levels of serum-neutrophil gelatinase-associated lipocalin were higher in those ventilated mechanically, compared to self-breathing patients. Although urine-neutrophil gelatinase-associated lipocalin levels were higher among mechanically ventilated patients than the controls, the difference was not statistically significant. CONCLUSION: Based on our study findings, we consider that neutrophil gelatinase-associated lipocalin may be a useful biomarker for emerging lung injuries due to mechanical ventilation in critically ill children and deserves to be investigated.