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.
Key words: ventilator-associated pneumonia, procalcitonin, lipopolysaccharide-binding protein
Author: Cleophas M. Rumende, Dinajani Mahdi
Journal Code: jpkedokterangg130255