Role of Combined Procalcitonin and Lipopolysaccharidebinding Protein as Prognostic Markers of Mortality in Patients with Ventilator-associated Pneumonia
ABSTRACT: to investigate the
role of combined Lipopolysaccharide-Binding Protein (LBP) and Procalcitonin (PCT)
) as prognostic marker of mortality in patients with Ventilator-Associated
Pneumonia (VAP). Methods: this prospective cohort study was held in ICU/HCU of
Cipto Mangunkusumo hospital between 2006 to 2007 by taking the subjects
consecutively. Thirty fve patients with VAP were studied. For analysing the
data, chi-square or its alternative Fisher exact test were used. Based on a
previous study for evaluation, we used cut off pants of 5 ng/ml and 0.5 ng/ml
for PCT and 30 µg/ml and 25 µg/ml for LBP after three-day and seven-day treatment
respectively. Receiver operating curve was made to determine the sensitivity
and specifcity of PCT and LBP as infection markers. Results: 35 patients
participated in this study. After three days of therapy, if the level of PCT
>5 ng/mL and LBP >30 µg/mL the prognosis would be bad (p<0.05) with a
sensitivity of 88.5%, specifcity of 53.2% and AUC value 0.69. Poor prognosis
was also found if after seven day therapy PCT level was >0.5 ng/mL and LBP
level >25 µg/mL (p<0.05) with sensitivity of 96.3%, specifcity of 66.7%
and AUC value 0.81. Conclusion: examination of combined PCT and LBP can be
taken as a good prognostic markers to predict mortality in patients with VAP.
Author: Cleophas M. Rumende,
Dinajani Mahdi
Journal Code: jpkedokterangg130255
