Abstract
The aim of the present study was to assess whether procalcitonin (PCT) can be used as a diagnostic marker for ventilator-associated pneumonia (VAP) in cardiac surgery patients. Between January 2012 and June 2013, a total of 92 patients were recruited and divided into non-VAP (59 patients) and VAP (33 patients) groups. The preoperative and postoperative characteristics of the patients were recorded. Serum levels of PCT, interleukin (IL)-6 and C-reactive protein (CRP) were measured using an electrochemiluminescence immunoassay. Subsequently, receiver operating characteristic curves of the PCT, IL-6 and CRP levels were constructed. In addition, associations between the sequential organ failure assessment (SOFA) scores and the serum levels of PCT, IL-6 and CRP in the VAP patients were analyzed. No statistically significant difference was observed between the non-VAP and VAP patients in the occurrence of postoperative complications. However, the SOFA scores (days 1 and 7), the duration of stay in the intensive care unit and the mechanical ventilation time were all significantly higher in the VAP group when compared with the non-VAP group (P<0.05). The optimum PCT cut-off value for VAP diagnosis on day 1 was 5.0 ng/ml, with a sensitivity of 91% and a specificity of 71%. The serum PCT levels on days 1 and 7 were found to correlate positively with the SOFA scores (r=0.54 and r=0.66 for days 1 and 7, respectively). Therefore, the results suggested that serum PCT may be used as diagnostic marker for VAP in patients following cardiac surgery.
Highlights
Major cardiac surgery patients are a high‐risk population for nosocomial infections [1]
Patients were excluded from the study if they had been diagnosed with pneumonia prior to the mechanical ventilation, were pregnant, had received immunosuppressants or long‐term corticosteroid therapy or had a coexisting extrapulmonary infection that required antibiotic therapy for more than three days prior to or following the cardiac surgery
The study focused on patients in the early stages of ventilator‐associated pneumonia (VAP) that had been diagnosed between 48 h and six days after initiation of the mechanical ventilation
Summary
Major cardiac surgery patients are a high‐risk population for nosocomial infections [1]. Early prevention, diagnosis and treatment of VAP is essential
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