C-reactive protein and procalcitonin profile in ventilator-associated lower respiratory infections

Luis Coelho, Ligia Rabello, Jorge Salluh, Ignacio Martin-Loeches, Alejandro Rodriguez, Saad Nseir, José Andrade Gomes, Pedro Povoa

Research output: Contribution to journalArticle

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Abstract

Purpose: Ventilator-associated tracheobronchitis (VAT) has been suggested as an intermediate process between tracheobronchial colonization and ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation. The aim of this study was to evaluate the ability of C-reactive protein (CRP) and procalcitonin (PCT) to differentiate between VAT and VAP. Methods: Pre-planned analysis of the prospective multinational TAVeM database, performed on 2960 patients receiving mechanical ventilation for >48 h, including 689 patients with VA-LRTI. Patients with the diagnosis of VAT or VAP microbiologically documented and with one measurement of CRP and/or PCT on the day of diagnosis were included. Results: Four hundred and four patients (mean age 63 years, 298 men, ICU mortality 40%) were studied, 207 with VAT and 197 with VAP. On the day of infection diagnosis, the median CRP was elevated in both groups but significantly higher in VAP (18 mg/dL vs. 14 mg/dL, p =.001). Median PCT was also significantly higher in VAP (2.1 ng/dL vs. 0.64 ng/d L, p <.001). Both biomarkers could not help distinguish between VAT and VAP. Conclusion: Although PCT and CRP presented lower values in VAT as compared to VAP, there was a marked overlap of both biomarkers values in both VA-LRTI not allowing adequate discrimination.

Original languageEnglish
Pages (from-to)385-389
Number of pages5
JournalJournal of critical care
Volume48
DOIs
Publication statusPublished - Dec 2018

Fingerprint

Ventilator-Associated Pneumonia
Calcitonin
Mechanical Ventilators
Respiratory Tract Infections
C-Reactive Protein
Artificial Respiration
Biomarkers
Databases
Mortality

Keywords

  • Biomarkers
  • C-reactive protein
  • Intensive care unit
  • Lower respiratory tract infections
  • Pneumonia
  • Procalcitonin
  • Tracheobronchitis
  • Ventilator-associated

Cite this

Coelho, Luis ; Rabello, Ligia ; Salluh, Jorge ; Martin-Loeches, Ignacio ; Rodriguez, Alejandro ; Nseir, Saad ; Gomes, José Andrade ; Povoa, Pedro. / C-reactive protein and procalcitonin profile in ventilator-associated lower respiratory infections. In: Journal of critical care. 2018 ; Vol. 48. pp. 385-389.
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abstract = "Purpose: Ventilator-associated tracheobronchitis (VAT) has been suggested as an intermediate process between tracheobronchial colonization and ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation. The aim of this study was to evaluate the ability of C-reactive protein (CRP) and procalcitonin (PCT) to differentiate between VAT and VAP. Methods: Pre-planned analysis of the prospective multinational TAVeM database, performed on 2960 patients receiving mechanical ventilation for >48 h, including 689 patients with VA-LRTI. Patients with the diagnosis of VAT or VAP microbiologically documented and with one measurement of CRP and/or PCT on the day of diagnosis were included. Results: Four hundred and four patients (mean age 63 years, 298 men, ICU mortality 40{\%}) were studied, 207 with VAT and 197 with VAP. On the day of infection diagnosis, the median CRP was elevated in both groups but significantly higher in VAP (18 mg/dL vs. 14 mg/dL, p =.001). Median PCT was also significantly higher in VAP (2.1 ng/dL vs. 0.64 ng/d L, p <.001). Both biomarkers could not help distinguish between VAT and VAP. Conclusion: Although PCT and CRP presented lower values in VAT as compared to VAP, there was a marked overlap of both biomarkers values in both VA-LRTI not allowing adequate discrimination.",
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C-reactive protein and procalcitonin profile in ventilator-associated lower respiratory infections. / Coelho, Luis; Rabello, Ligia; Salluh, Jorge; Martin-Loeches, Ignacio; Rodriguez, Alejandro; Nseir, Saad; Gomes, José Andrade; Povoa, Pedro.

In: Journal of critical care, Vol. 48, 12.2018, p. 385-389.

Research output: Contribution to journalArticle

TY - JOUR

T1 - C-reactive protein and procalcitonin profile in ventilator-associated lower respiratory infections

AU - Coelho, Luis

AU - Rabello, Ligia

AU - Salluh, Jorge

AU - Martin-Loeches, Ignacio

AU - Rodriguez, Alejandro

AU - Nseir, Saad

AU - Gomes, José Andrade

AU - Povoa, Pedro

PY - 2018/12

Y1 - 2018/12

N2 - Purpose: Ventilator-associated tracheobronchitis (VAT) has been suggested as an intermediate process between tracheobronchial colonization and ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation. The aim of this study was to evaluate the ability of C-reactive protein (CRP) and procalcitonin (PCT) to differentiate between VAT and VAP. Methods: Pre-planned analysis of the prospective multinational TAVeM database, performed on 2960 patients receiving mechanical ventilation for >48 h, including 689 patients with VA-LRTI. Patients with the diagnosis of VAT or VAP microbiologically documented and with one measurement of CRP and/or PCT on the day of diagnosis were included. Results: Four hundred and four patients (mean age 63 years, 298 men, ICU mortality 40%) were studied, 207 with VAT and 197 with VAP. On the day of infection diagnosis, the median CRP was elevated in both groups but significantly higher in VAP (18 mg/dL vs. 14 mg/dL, p =.001). Median PCT was also significantly higher in VAP (2.1 ng/dL vs. 0.64 ng/d L, p <.001). Both biomarkers could not help distinguish between VAT and VAP. Conclusion: Although PCT and CRP presented lower values in VAT as compared to VAP, there was a marked overlap of both biomarkers values in both VA-LRTI not allowing adequate discrimination.

AB - Purpose: Ventilator-associated tracheobronchitis (VAT) has been suggested as an intermediate process between tracheobronchial colonization and ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation. The aim of this study was to evaluate the ability of C-reactive protein (CRP) and procalcitonin (PCT) to differentiate between VAT and VAP. Methods: Pre-planned analysis of the prospective multinational TAVeM database, performed on 2960 patients receiving mechanical ventilation for >48 h, including 689 patients with VA-LRTI. Patients with the diagnosis of VAT or VAP microbiologically documented and with one measurement of CRP and/or PCT on the day of diagnosis were included. Results: Four hundred and four patients (mean age 63 years, 298 men, ICU mortality 40%) were studied, 207 with VAT and 197 with VAP. On the day of infection diagnosis, the median CRP was elevated in both groups but significantly higher in VAP (18 mg/dL vs. 14 mg/dL, p =.001). Median PCT was also significantly higher in VAP (2.1 ng/dL vs. 0.64 ng/d L, p <.001). Both biomarkers could not help distinguish between VAT and VAP. Conclusion: Although PCT and CRP presented lower values in VAT as compared to VAP, there was a marked overlap of both biomarkers values in both VA-LRTI not allowing adequate discrimination.

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KW - C-reactive protein

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SN - 0883-9441

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