Περίληψη:
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.
Συγγραφείς:
Hillas, G.
Vassilakopoulos, T.
Plantza, P.
Rasidakis, A. and
Bakakos, P.
