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Abstract

Pneumonia remains a major global health challenge, with significant mortality rates and complications such as acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). In severe cases, mechanical ventilation becomes essential for managing respiratory failure but can also worsen lung injury through ventilator-induced lung injury (VILI). During lung injury, such as in severe pneumonia, Syndecan-1 (SDC-1) is shed from the cell surface into circulation and the alveolar space. Elevated SDC-1 levels have been associated with the severity of lung injury, making it a potential biomarker for assessing disease progression and guiding treatment strategies. The purpose of this study is to look into the potential of SDC-1, a glycocalyx component, as a predictive biomarker for lung damage severity in pneumonia patients requiring mechanical ventilation. Bronchoalveolar lavage (BAL) samples were obtained from 30 patients in an Intensive Care Unit (ICU), and SDC-1 levels were determined using ELISA. Elevated SDC-1 levels were associated with greater Lung Injury Scores (LIS) and severe hypoxemia (p < 0.001). Patients with severe lung injury had significantly greater SDC-1 levels than those with mild-to-moderate injury, indicating that SDC-1 reflects the severity of alveolar epithelial damage and impeded gas exchange. These data suggest that SDC-1 might be a useful biomarker for tracking lung damage development and directing treatment therapies in mechanically ventilated pneumonia patients‎.

Keywords: Biomarkers, Bronchoalveolar Lavage fluid, Mechanical ventilator, Pneumonia, Syndecan-1

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