Procalcitonin (PCT) versus IL-6 levels in bronchoalveolar lavage (BAL) fluids of trauma victims with severe lung contusion

Objective

To examine whether measurement of procalcitonin (PCT) in comparison to Interleukin 6 (IL-6) is a reliable marker to score the extent of lung contusion in bronchoalveolar lavage (BAL) fluids in polytrauma patients.

Design

Prospective, non-randomized observational study.

Setting

Twelve-bed ICU in a 1100-bed primary care university hospital.

Patients

n = 14 trauma victims presenting with severe lung contusion and acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) were enrolled in the study.

Interventions

Bronchoscopy with collection of lavage fluid and serum blood samples. Samples were obtained on day 1 and day 2 after severe chest trauma, and lung contusion was assessed by CT scan.

Measurements and main results

PCT was detectable in bronchoalveolar lavage (BAL) fluids of all 14 patients. A significant correlation for PCT serum and BAL levels was found on day 2 (P = 0.0063). For PCT no significant correlations (Spearman rank) were found to the lung injury score (LIS) (P = 0.93), the abbreviated injury scale (AIS-lung) (P = 0.33) and the sepsis-related organ failure assessment score (SOFA-lung) (P = 0.38). Also for IL-6 there was no significant correlation to the LIS score (P = 0.62), AIS-score lung (P = 0.45) and to the SOFA-score lung (P = 0.54).

Conclusions

PCT and IL-6 BAL levels cannot be considered as reliable parameters to assess the extent of lung contusion.