| Semi-quantitative Procalcitonin Assay in Critically ill Patients with Respiratory infections. |
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Ji Youn Kim, 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 |
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Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea. kimch2002@hallym.or.kr |
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| 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. |
| Key Words:
Bronchoaveolar lavage, Procalcitonin, Respiratory infections, Ventilator-associated pneumonia |
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