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Prognostic Role of Serum Adrenomedullin in Patients with Ventilator Associated Pneumonia

Tamer Abdallah Helmy1, Haitham Hamdy Tammam1, Michael Ebrahim Leuis1

  • 1Critical Care Medicine Department, Faculty of Medicine, Alexandria University, Alexandria 5424010, Egypt.

Advances in Respiratory Medicine
|August 25, 2022
PubMed
Abstract

Insights

Serum adrenomedullin (ADM) can predict poor outcomes in patients with ventilator-associated pneumonia (VAP). Higher ADM levels at diagnosis and 5 days later indicate a worse prognosis, with ADM showing greater predictive power than other markers.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Biomarkers

Background:

  • Ventilator-associated pneumonia (VAP) is a frequent complication in mechanically ventilated patients, often leading to sepsis and septic shock.
  • Current diagnostic methods for VAP have limitations.
  • Adrenomedullin (ADM) is a peptide hormone found to be elevated in sepsis patients.

Purpose of the Study:

  • To investigate the prognostic value of serum adrenomedullin (ADM) in patients diagnosed with ventilator-associated pneumonia (VAP).
  • To compare the predictive capability of ADM against established clinical and laboratory markers.

Main Methods:

  • A prospective observational study was conducted in an Intensive Care Department.
  • 140 patients with confirmed VAP were enrolled.
  • Serum ADM, APACHE II score, SOFA score, CRP, and lactate were measured at VAP diagnosis (day 0) and 5 days later, correlating with patient outcomes.

Main Results:

  • Serum ADM, APACHE II score, and lactate on day 0 were predictive of unfavorable outcomes.
  • ADM demonstrated significantly higher predictive power than APACHE II and lactate.
  • ADM measured on day 0 exhibited the highest sensitivity (96.25%) for predicting unfavorable outcomes.

Conclusions:

  • Serum adrenomedullin levels measured at days 0 and 5 of VAP diagnosis can serve as an early and effective predictor of unfavorable outcomes.
  • ADM shows promise as a valuable prognostic biomarker in VAP management.
Keywords:
adrenomedullinmortalityprolonged mechanical ventilationsepsisseptic shockventilator associated pneumonia

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