C-reactive protein and procalcitonin as predictors of survival and septic shock in ventilator-associated pneumonia

Hillas, Georgios; Vassilakopoulos, T.; Plantza, P.; Rasidakis, A; Bakakos, Petros

doi:10.1183/09031936.00051309

Cited by 76 publications

(85 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…AUC values were slightly better on day 3 and 5 after VAP onset (data not shown) However, since parameters assessed at VAP onset are statistically more robust and clinically more relevant we focused on the very first day. Nonetheless, our figures are lower than those described by others [20,21,50]. DUFLO et al [20] reported an AUC of 0.79 using PCT for predicting VAP-associated mortality.…”

Section: Combination Of Mr-proanp Pct and Icu Scorescontrasting

confidence: 55%

Midregional pro-atrial natriuretic peptide and procalcitonin improve survival prediction in VAP

Boeck¹,

Eggimann²,

Smyrnios³

et al. 2010

European Respiratory Journal

View full text Add to dashboard Cite

Ventilator-associated pneumonia (VAP) affects mortality, morbidity and cost of critical care. Reliable risk estimation might improve end-of-life decisions, resource allocation and outcome. Several scoring systems for survival prediction have been established and optimised over the last decades. Recently, new biomarkers have gained interest in the prognostic field. We assessed whether midregional pro-atrial natriuretic peptide (MR-proANP) and procalcitonin (PCT) improve the predictive value of the Simplified Acute Physiologic Score (SAPS) II and Sequential Related Organ Failure Assessment (SOFA) in VAP.Specified end-points of a prospective multinational trial including 101 patients with VAP were analysed. Death ,28 days after VAP onset was the primary end-point.MR-proANP and PCT were elevated at the onset of VAP in nonsurvivors compared with survivors (p50.003 and p50.017, respectively) and their slope of decline differed significantly (p50.018 and p50.039, respectively). Patients with the highest MR-proANP quartile at VAP onset were at increased risk for death (log rank p50.013). In a logistic regression model, MR-proANP was identified as the best predictor of survival. Adding MR-proANP and PCT to SAPS II and SOFA improved their predictive properties (area under the curve 0.895 and 0.880).We conclude that the combination of two biomarkers, MR-proANP and PCT, improve survival prediction of clinical severity scores in VAP.

show abstract

Section: Combination Of Mr-proanp Pct and Icu Scorescontrasting

confidence: 55%

Midregional pro-atrial natriuretic peptide and procalcitonin improve survival prediction in VAP

Boeck¹,

Eggimann²,

Smyrnios³

et al. 2010

European Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…It has been demonstrated that CRP may take part in the pathogenesis of atherosclerosis through the promotion of endothelial cell activation and foam cell generation within the arterial wall (19,20). Previous studies have identified the significant role of the serum CRP level in the development and prognosis of pneumonia, and have reported that an increased serum level of CRP may be present in patients with pneumonia (21,22). In particular, it has been found that the serum CRP level may be useful for distinguishing bacterial pneumonia from nonbacterial pneumonia in children, as higher serum CRP concentrations were observed in cases with a bacterial etiology (23,24).…”

Section: Introductionmentioning

confidence: 99%

Correlation between serum levels of C-reactive protein and infant pneumonia: A meta-analysis

Xiao

Xue

Sheng

et al. 2015

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. Experimental data imply that serum C-reactive protein (CRP) is a marker of general systemic inflammation, and inflammation may have a role in the development of pneumonia. The aim of the present study was to investigate the associations of serum CRP levels in infant patients with pneumonia by meta-analysis. The Science Citation Index, Cochrane Library, PubMed, Embase, CINAHL, Current Contents and two Chinese (CMB and CNKI) databases were searched. Studies were pooled and standard mean difference (SMD) and the corresponding 95% confidence interval (CI) were calculated. Subgroup analyses and publication bias detection were also conducted. The statistical analysis was conducted using Stata software version 12.0. Serum CRP levels were analyzed in 10 clinical case-control studies (652 infants with pneumonia and 845 healthy controls); significant differences in serum CRP levels were observed between infants with pneumonia and the healthy controls (SMD=4.41, 95% CI: 3.34-5.47, P<0.001). Ethnicity-stratified subgroup analysis detected that high levels of serum CRP may be the main risk factor for infant pneumonia in Asian, African and Caucasian populations (all P<0.05). Serum CRP levels were statistically higher in infants with pneumonia than in healthy infants, and thus serum levels of CRP may have independent diagnostic value for pneumonia in children.

show abstract

“…SIRS was defi ned as the presence of two or more of the following: temperature greater than 38 °C or less than 35 °C, heart rate greater than 90 bpm, respiratory rate greater than 20 bpm or PaCO 2 <32 mmHg, white blood cell count greater than 12×10 9 /L or less than 4.0×10 9 /L or relative count of immature cells greater than 10% of total leukocytes. [6] Shock was defined as systolic blood pressure <90 mmHg or 40 mmHg lower than basic blood pressure for more than one hour or in need of vasoactive drugs. [2] Acute kidney injury was defined as absolute rise in serum creatinine of ≥0.3 mg/dL (≥26.4 μmol/L), increase in serum creatinine of ≥50%, reduction in urine output, defined as <0.5 mL/kg per hour for more than 6 hours.…”

Section: Defi Nitionmentioning

confidence: 99%

Risk factors and prognosis of critically ill cancer patients with postoperative acute respiratory insufficiency

Xing

Gao

Wang

et al. 2013

World Journal of Emergency Medicine

View full text Add to dashboard Cite

BACKGROUND: This study aimed to investigate the risk factors and outcome of critically ill cancer patients with postoperative acute respiratory insuffi ciency. METHODS:The data of 190 critically ill cancer patients with postoperative acute respiratory insuffi ciency were retrospectively reviewed. The data of 321 patients with no acute respiratory insuffi ciency as controls were also collected. Clinical variables of the fi rst 24 hours after admission to intensive care unit were collected, including age, sex, comorbid disease, type of surgery, admission type, presence of shock, presence of acute kidney injury, presence of acute lung injury/acute respiratory distress syndrome, acute physiologic and chronic health evaluation (APACHE II) score, sepsis-related organ failure assessment (SOFA), and PaO 2 /FiO 2 ratio. Duration of mechanical ventilation, length of intensive care unit stay, intensive care unit death, length of hospitalization, hospital death and one-year survival were calculated. RESULTS:The incidence of acute respiratory insufficiency was 37.2% (190/321). Multivariate logistic analysis showed a history of chronic obstructive pulmonary diseases (P=0.001), surgeryrelated infection (P=0.004), hypo-volemic shock (P<0.001), and emergency surgery (P=0.018), were independent risk factors of postoperative acute respiratory insufficiency. Compared with the patients without acute respiratory insuffi ciency, the patients with acute respiratory insuffi ciency had a prolonged length of intensive care unit stay (P<0.001), a prolonged length of hospitalization (P=0.006), increased intensive care unit mortality (P=0.001), and hospital mortality (P<0.001). Septic shock was shown to be the only independent prognostic factor of intensive care unit death for the patients with acute respiratory insufficiency (P=0.029, RR: 8.522, B=2.143, SE=0.982, Wald=4.758). Compared with the patients without acute respiratory insufficiency, those with acute respiratory insuffi ciency had a shortened one-year survival rate (78.7% vs. 97.1%, P<0.001).CONCLUSION: A history of chronic obstructive pulmonary diseases, surgery-related infection, hypovolemic shock and emergency surgery were risk factors of critically ill cancer patients with postoperative acute respiratory insuffi ciency. Septic shock was the only independent prognostic factor of intensive care unit death in patients with acute respiratory insufficiency. Compared with patients without acute respiratory insufficiency, those with acute respiratory insufficiency had adverse shortterm outcome and a decreased one-year survival rate.

show abstract

C-reactive protein and procalcitonin as predictors of survival and septic shock in ventilator-associated pneumonia

Cited by 76 publications

References 38 publications

Midregional pro-atrial natriuretic peptide and procalcitonin improve survival prediction in VAP

Midregional pro-atrial natriuretic peptide and procalcitonin improve survival prediction in VAP

Correlation between serum levels of C-reactive protein and infant pneumonia: A meta-analysis

Risk factors and prognosis of critically ill cancer patients with postoperative acute respiratory insufficiency

Contact Info

Product

Resources

About