Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia
Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia
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DOI：
10.1164/rccm.200406-746oc
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发表时间：
2005-01-01
影响因子：
24.7
通讯作者：
Chastre, J
中科院分区：
文献类型：
--
作者：
Luyt, CE;Guérin, V;Chastre, J
我们研究了降钙素原动力学作为呼吸机相关性肺炎（VAP）预后指标的价值。这项前瞻性观察性研究在一所大学医院的重症监护室进行。纳入所有诊断后存活3天的经微生物学证实的VAP连续患者，并根据临床结局进行分组：有利或不利，定义为死亡、VAP复发或第28天前需要抗生素的肺外感染。在第1、3和7天测量所有患者的血清降钙素原水平。在纳入的63名患者中，38名患者的结局不利。在第1天，他们比结局良好的患者病情更严重。血清降钙素原水平在VAP的临床过程中降低，但在预后不良的患者中，从第1天到第7天显著升高。多变量分析保留第1、3和7天的血清降钙素原水平作为不利结局的强预测因子。基于这些数据，降钙素原可能是VAP预后的标志物。
We investigated the value of procalcitonin kinetics as a prognostic marker during ventilator-associated pneumonia (VAP). This prospective, observational study was conducted in a medical intensive care unit in a university hospital. All consecutive patients with microbiologically proven VAP who survived 3 days after its diagnosis were included and grouped according to clinical outcome: favorable or unfavorable, defined as death, VAP recurrence, or extrapulmonary infection requiring antibiotics before Day 28. Serum procalcitonin levels were measured on Days 1, 3, and 7 for all patients. Among the 63 patients included, 38 had unfavorable outcomes. On Day 1, they were more critically ill than patients with a favorable outcome. Serum procalcitonin levels decreased during the clinical course of VAP but were significantly higher from Day I to Day 7 in patients with unfavorable outcomes. Multivariate analyses retained serum procalcitonin levels on Days 1, 3, and 7 as strong predictors of unfavorable outcome. Based on these data, procalcitonin could be a prognostic marker of outcome during VAP.