Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Semi-quantitative Procalcitonin Assay in Critically ill Patients with Respiratory infections

중환자 호흡 감염에서 반정량적 Procalcitonin 분석

  • Kim, Ji-Youn (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Cheol-Hong (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Park, Sunghoon (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Lee, Chang-Youl (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Hwang, Yong Il (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Choi, Jeong-Hee (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Shin, Taerim (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Park, Yong-Bum (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Jang, Seung-Hun (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Lee, Jae Young (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Park, Sang Myeon (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Dong-Gyu (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Lee, Myung-Goo (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Hyun, In-Gyu (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Jung, Ki-Suck (Department of Internal Medicine, Hallym University College of Medicine)
  • 김지연 (한림대학교 의과대학 내과학교실) ;
  • 김철홍 (한림대학교 의과대학 내과학교실) ;
  • 박성훈 (한림대학교 의과대학 내과학교실) ;
  • 이창률 (한림대학교 의과대학 내과학교실) ;
  • 황용일 (한림대학교 의과대학 내과학교실) ;
  • 최정희 (한림대학교 의과대학 내과학교실) ;
  • 신태림 (한림대학교 의과대학 내과학교실) ;
  • 박용범 (한림대학교 의과대학 내과학교실) ;
  • 장승훈 (한림대학교 의과대학 내과학교실) ;
  • 이재영 (한림대학교 의과대학 내과학교실) ;
  • 박상면 (한림대학교 의과대학 내과학교실) ;
  • 김동규 (한림대학교 의과대학 내과학교실) ;
  • 이명구 (한림대학교 의과대학 내과학교실) ;
  • 현인규 (한림대학교 의과대학 내과학교실) ;
  • 정기석 (한림대학교 의과대학 내과학교실)
  • Received : 2009.07.02
  • Accepted : 2009.09.01
  • Published : 2009.09.30
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Abstract

Background: Serum procalcitonin level has been considered prognostic during sepsis and septic shock. We investigated the significance of procalcitonin in critically ill patients with respiratory infections. Methods: The patients who had radiographically diagnosed diffuse lung infiltrations were enrolled on a prospective basis. Bronchoalveolar lavage (BAL) fluid for the purpose of quantitative cultures (${\geq}10^4$ cfu/mL) was obtained from all patients. Serum procalcitonin levels determined by PCT-Q kit were measured on BAL day and classified as follows; <0.5 ng/mL, 0.5~2.0 ng/mL, 2.0~10.0 ng/mL and >10.0 ng/mL. We analyzed the patient's characteristics according to outcome; favorable or unfavorable, defined as death. Results: Patients from the following categories were included: medical 17 (47.2%), surgical 9 (25%), and burned 10 (27.8%). APACHE II scores on admission to intensive care unit were 11.5${\pm}$6.89 and 11 (30.6%) had unfavorable outcomes. A procalcitonin level ${\geq}$0.5 ng/mL was in 17 (47.2%) of all. On univariate analysis, the frequencies of burn injury, mechanical ventilation, multiple organ failure, and a procalcitonin level ${\geq}$0.5 ng/mL were more often increased in patients with unfavorable outcomes than in those with favorable outcomes (p<.05). Also, a higher procalcitonin range and ventilator-associated pneumonia (VAP) were more closely associated with an unfavorable outcome (p<.05). However in multivariate analysis, a strong predictor of unfavorable outcome was burn injury (p<.05). A procalcitonin level ${\geq}$0.5 ng/mL was more sensitive in predicting VAP than unfavorable outcome. Conclusion: A higher procalcitonin level seems to be associated with VAP, but further study is required to know that procalcitonin would be a prognostic marker in critically ill patients with respiratory infections.

Keywords

References

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