Introduction
Diagnosis of ventilator-associated pneumonia (VAP) can be difficult which often a large associated infectious or inflammatory diseases. The aim of our study was to describe systemic inflammatory response to VAP with the help of procalcitonin (PCT), CRP and cytokines.
Methods
In a prospective study, we studied all patients in our ICU with VAP between January 2000 and September 2000. PCT, CRP and cytokines (TNF, IL-6, IL-8) were measured at admission (J0), on second day (J2) and on fourth and seventh day (J4, J7). Prognostic indicators of severity were recorded on admission: Apache II, IGS II and SOFA score.
Results
Twenty-four consecutive patients (mean age 52 ± 17 years, mean IGS II 38 ± 15, mean Apache II 15 ± 6) were admitted in ICU. Mortality rate was 45% (11 patients).
Discussion
PCT seems to be a good marker of the intensity of inflammatory response to infection during VAP with PCT values often under 5 ng/ml. So higher PCT levels may be related to another sepsis and another aetiology must be researched.
Table 1.
| J0 | J2 | J4 | J7 | J14 | |
|---|---|---|---|---|---|
| PCT (ng/ml) | 5.27 ± 14.14 | 6.01 ± 12.65 | 10.79 ± 26.26 | 10.52 ± 26.52 | 2.99 ± 8.44 |
| CRP (mg/ml) | 191 ± 68 | 215 ± 62 | 163 ± 92 | 147 ± 106 | 68 ± 84 |
| TNF (pg/ml) | 10 ± 9 | 8 ± 8 | 10 ± 9 | – | – |
| IL-6 (pg/ml) | 628 ± 1491 | 611 ± 1703 | 328 ± 602 | – | – |
| IL-8 (pg/ml) | 111 ± 248 | 78 ± 183 | 66 ± 129 | – | – |