Unidad de Cuidados Intensivos, Hospital Eva Perón, Granadero Baigorria, Santa Fe, Argentina.
Unidad de Cuidados Intensivos, Hospital Eva Perón, Granadero Baigorria, Santa Fe, Argentina.
Med Clin (Barc). 2019 Mar 15;152(6):216-221. doi: 10.1016/j.medcli.2018.06.019. Epub 2018 Aug 25.
Procalcitonin (PCT) can help the early diagnosis of bacterial infections and estimate the response obtained. The objective is to study the value of PCT for the diagnosis of ventilator-associated pneumonia (VAP).
Prospective and observational study, carried out for 18 months, in a polyvalent Intensive Care Unit (ICU). Those included were over 18 years of age, with suspected pneumonia after 48h of mechanical ventilation (MV). Collected were demographic characteristics; admission pathology; reason for beginning MV; gravity scores (APACHE II, SAPS II and SOFA); C-reactive protein (CRP) and PCT. At the time of suspicion of VAP: early or late, radiological severity, presence of septic shock, SOFA, CRP, PCT and microbiology.
Ninety-one patients with suspected VAP were included. The mean age was 42 (17.76) and that of hospitalisation in the ICU was 18.59 (11.69) days. VAP was confirmed in 74 patients, of which 19 (25.7%) presented septic shock. The mortality was 28.4%. There were no significant differences of the PCT in the patients who presented VAP versus those who did not present VAP (P=.449). When patients without VAP, with VAP and VAP with shock, were compared, the PCT median was 0.38 (CI95%: 0.22-1.90), 0.56 (CI95%: 0.19-1.77) and 1.93 (CI95%: 0.38-10.07), respectively (P=.169).
In our study, PCT did not prove useful for the diagnosis of VAP.
降钙素原（PCT）有助于早期诊断细菌感染并评估治疗反应。本研究旨在评估 PCT 对呼吸机相关性肺炎（VAP）的诊断价值。
前瞻性观察研究，在多学科重症监护病房（ICU）进行，时间为 18 个月。纳入标准为年龄＞18 岁，机械通气（MV）48h 后疑似肺炎。收集患者的人口统计学特征、入院时疾病情况、MV 起始原因、严重程度评分（APACHE II、SAPS II 和 SOFA）、C 反应蛋白（CRP）和 PCT。在疑似 VAP 时：早期或晚期、放射学严重程度、是否存在感染性休克、SOFA、CRP、PCT 和微生物学检查。
共纳入 91 例疑似 VAP 患者，平均年龄 42（17.76）岁，ICU 住院时间为 18.59（11.69）天。74 例患者确诊为 VAP，其中 19 例（25.7%）发生感染性休克，死亡率为 28.4%。有 VAP 与无 VAP 患者的 PCT 无显著差异（P=.449）。比较无 VAP、有 VAP 和 VAP 伴休克的患者，PCT 中位数分别为 0.38（95%CI：0.22-1.90）、0.56（95%CI：0.19-1.77）和 1.93（95%CI：0.38-10.07）（P=.169）。
本研究中，PCT 对 VAP 的诊断无帮助。
