Semi-quantitative Procalcitonin Assay in Critically ill Patients with Respiratory infections.
10.4046/trd.2009.67.3.205
- Author:
Ji Youn KIM
1
;
Cheol Hong KIM
;
Sunghoon PARK
;
Chang Youl LEE
;
Yong Il HWANG
;
Jeong Hee CHOI
;
Taerim SHIN
;
Yong Bum PARK
;
Seung Hun JANG
;
Jae Young LEE
;
Sang Myeon PARK
;
Dong Gyu KIM
;
Myung Goo LEE
;
In Gyu HYUN
;
Ki Suck JUNG
Author Information
1. Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea. kimch2002@hallym.or.kr
- Publication Type:Original Article
- Keywords:
Bronchoaveolar lavage;
Procalcitonin;
Respiratory infections;
Ventilator-associated pneumonia
- MeSH:
APACHE;
Bronchoalveolar Lavage;
Burns;
Calcitonin;
Critical Illness;
Humans;
Intensive Care Units;
Lung;
Multiple Organ Failure;
Multivariate Analysis;
Pneumonia, Ventilator-Associated;
Prospective Studies;
Protein Precursors;
Respiration, Artificial;
Respiratory Tract Infections;
Sepsis;
Shock, Septic
- From:Tuberculosis and Respiratory Diseases
2009;67(3):205-211
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Serum procalcitonin level has been considered prognostic during sepsis and septic shock. We investigated the significance of procalcitonin in critically ill patients with respiratory infections. METHODS: The patients who had radiographically diagnosed diffuse lung infiltrations were enrolled on a prospective basis. Bronchoalveolar lavage (BAL) fluid for the purpose of quantitative cultures (> or =10(4) cfu/mL) was obtained from all patients. Serum procalcitonin levels determined by PCT-Q kit were measured on BAL day and classified as follows; <0.5 ng/mL, 0.5~2.0 ng/mL, 2.0~10.0 ng/mL and >10.0 ng/mL. We analyzed the patient's characteristics according to outcome; favorable or unfavorable, defined as death. RESULTS: Patients from the following categories were included: medical 17 (47.2%), surgical 9 (25%), and burned 10 (27.8%). APACHE II scores on admission to intensive care unit were 11.5+/-6.89 and 11 (30.6%) had unfavorable outcomes. A procalcitonin level > or =0.5 ng/mL was in 17 (47.2%) of all. On univariate analysis, the frequencies of burn injury, mechanical ventilation, multiple organ failure, and a procalcitonin level > or =0.5 ng/mL were more often increased in patients with unfavorable outcomes than in those with favorable outcomes (p<.05). Also, a higher procalcitonin range and ventilator-associated pneumonia (VAP) were more closely associated with an unfavorable outcome (p<.05). However in multivariate analysis, a strong predictor of unfavorable outcome was burn injury (p<.05). A procalcitonin level > or =0.5 ng/mL was more sensitive in predicting VAP than unfavorable outcome. CONCLUSION: A higher procalcitonin level seems to be associated with VAP, but further study is required to know that procalcitonin would be a prognostic marker in critically ill patients with respiratory infections.
