@article{3145553, title = "C-reactive protein and procalcitonin as predictors of survival and septic shock in ventilator-associated pneumonia", author = "Hillas, G. and Vassilakopoulos, T. and Plantza, P. and Rasidakis, A. and and Bakakos, P.", journal = "The European respiratory journal", year = "2010", volume = "35", number = "4", pages = "805-811", publisher = "EUROPEAN RESPIRATORY SOC JOURNALS LTD", doi = "10.1183/09031936.00051309", keywords = "C-reactive protein; outcome; procalcitonin; septic shock; Sequential Organ Failure Assessment score; ventilator-associated pneumonia", abstract = "We evaluated the performance of procalcitonin (PCT) and C-reactive protein (CRP) threshold values and kinetics as predictors of ventilator-associated pneumonia (VAP) survival and septic shock development. 45 adult patients with VAP were studied. Serum CRP and PCT levels and the Sequential Organ Failure Assessment (SOFA) score were measured on days 1, 4 and 7 (D1, D4, D7) of VAP and their variations between different days (kinetics) were calculated (Delta PCT, Delta CRP). A multivariate logistic regression model was constructed with either VAP 28-day survival or septic shock development as dependent variables, and PCT values, CRP values, kinetics, age, sex, SOFA and Acute Physiology and Chronic Health Evaluation (APACHE) II score as independent variables. No difference was found in CRP levels between survivors and nonsurvivors. Nonsurvivors had significantly higher PCT levels on D1 and D7. In the multivariate analysis, the only factors predicting VAP survival were Delta PCT7-1 (OR 7.23, 95% CI 0.008-0.468) and Delta CRP7-4 (OR 4.59, 95% CI 0.013-0.824). VAP patients who developed septic shock had significantly higher CRP levels on D1 and D7 and higher PCT levels on D1 and D4. The only factor predicting the development of septic shock was SOFA on D1 (OR 7.44, 95% CI 1.330-5.715). Neither PCT and CRP threshold values nor their kinetics can predict VAP survival or septic shock development." }