Systemic inflammatory response during ventilator-associated pneumonia

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.

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