Abstract
Ventilator-associated pneumonia (VAP) is a complication in as many as 28% of patients who receive mechanical ventilation. Studies have consistently shown that a delay in diagnosis and treatment increases the mortality risk. The aim of this work was to clarify the role of the serum procalcitonin (PCT) in the diagnosis and the prognosis of ventilator associated pneumonia. Methods: Forty two VAP patients, 20 non VAP-ICU (on mechanical ventilation) admitted patients and 20 healthy control subjects of similar age and sex were included in the study. PCT levels in serum samples were measured in all subjects. Results: There was a highly statistically significant difference (p value 0.001) between VAP patients on one side and non VAP-ICU patients and healthy control subjects on the other side regarding the mean values of PCT. Also, the mean values of PCT were statistically significantly higher (p 0.001) among died VAP group than the survivor VAP group. There was a statistically positive correlation (p = 0.449), CRIP (R = 0.403) and SOFA (R = 0.437)) and initial PCT serum levels. Conclusions: This study found that the increased PCT serum level is an important diagnostic tool for VAP and the PCT serum levels can predict the outcome of VAP patients. We recommend other larger studies to augment our findings.
Highlights
Ventilator-associated pneumonia (VAP) is pneumonia that develops 48 hours or longer after mechanical ventilation is given by means of an endotracheal tube or tracheostomy
There was a highly statistically significant difference (p value < 0.001) between VAP patients on one side and non VAP-ICU patients and healthy control subjects on the other side regarding the mean values of PCT
This study found that the increased PCT serum level is an important diagnostic tool for VAP and the PCT serum levels can predict the outcome of VAP patients
Summary
Ventilator-associated pneumonia (VAP) is pneumonia that develops 48 hours or longer after mechanical ventilation is given by means of an endotracheal tube or tracheostomy. Ventilator-associated pneumonia (VAP) results from the invasion of the lower respiratory tract and lung parenchyma by microorganisms. Ventilator associated pneumonia (VAP) is a complication in as many as 28% of patients who receive mechanical ventilation. The incidence of VAP increases with the duration of mechanical ventilation. Estimated rates are 3% per day for the first 5 days, 2% per day for days 6 - 10, and 1% per day after day 10 [2]. The crude mortality rate of VAP is 27% - 76%. Studies have consistently shown that a delay in starting appropriate and adequately dosed antibiotic therapy increases the mortality risk
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