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Diagnostic value of procalcitonin in ventilator-associated pneumonia

María Florencia Corbacho Re1, Nicolás Sebastián Rocchetti1, Claudio Jesús Settecase1

  • 1Unidad de Cuidados Intensivos, Hospital Eva Perón, Granadero Baigorria, Santa Fe, Argentina.

Medicina Clinica
|August 30, 2018
PubMed

Insights

Procalcitonin (PCT) did not aid in diagnosing ventilator-associated pneumonia (VAP). This study found no significant differences in PCT levels between patients with and without VAP, suggesting it is not a reliable biomarker for VAP diagnosis.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pulmonology

Background:

  • Procalcitonin (PCT) is a biomarker used for diagnosing bacterial infections and monitoring treatment response.
  • Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in intensive care units (ICUs).
  • Early and accurate diagnosis of VAP is crucial for appropriate antibiotic management and patient outcomes.

Purpose of the Study:

  • To evaluate the diagnostic value of procalcitonin (PCT) in patients suspected of having ventilator-associated pneumonia (VAP).
  • To determine if PCT levels can differentiate between patients with and without VAP.
  • To assess the utility of PCT in identifying VAP, particularly in cases with septic shock.

Main Methods:

  • A prospective, observational study was conducted over 18 months in a polyvalent Intensive Care Unit (ICU).
  • Ninety-one adult patients (over 18 years) with suspected VAP after 48 hours of mechanical ventilation (MV) were included.
  • Data collected included demographics, clinical characteristics, severity scores (APACHE II, SAPS II, SOFA), C-reactive protein (CRP), PCT levels, and microbiological results.

Main Results:

  • Of 91 patients, VAP was confirmed in 74 (81.3%); 19 (25.7%) presented with septic shock, and overall mortality was 28.4%.
  • No statistically significant differences in PCT levels were observed between patients with VAP and those without (P=.449).
  • Median PCT levels showed no significant difference across groups: no VAP (0.38), VAP (0.56), and VAP with shock (1.93) (P=.169).

Conclusions:

  • Procalcitonin (PCT) did not demonstrate utility as a diagnostic biomarker for ventilator-associated pneumonia (VAP) in this study population.
  • The findings suggest that PCT is not a reliable indicator for diagnosing VAP, even in the presence of septic shock.
  • Further research may be needed to explore other biomarkers or diagnostic strategies for VAP.
Abstract

Keywords:
BiomarcadoresBiomarkersCritical careCuidados intensivosDiagnosisDiagnósticoNeumonía asociada a ventiladorProcalcitoninProcalcitoninaVentilator-associated pneumonia

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