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

摘要

PurposeVentilator-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. MethodsPre-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. ResultsFour 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?