중환자 호흡 감염에서 반정량적 Procalcitonin 분석 (Semi-quantitative Procalcitonin Assay in Critically ill Patients with Respiratory infections)

서지정보

· 발행기관 : 대한결핵및호흡기학회
· 수록지 정보 : Tuberculosis and Respiratory Diseases / 67권 / 3호 / 205 ~ 211페이지
· 저자명 : 김지연, 박성훈, 이창률, 황용일, 최정희, 신태림, 박용범, 장승훈, 이재영, 박상면, 김동규, 이명구, 현인규, 정기석, 김철홍

초록

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 (≥104 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±6.89 and 11 (30.6%) had unfavorable outcomes. A procalcitonin level ≥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 ≥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 ≥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.

영어초록

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 (≥104 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±6.89 and 11 (30.6%) had unfavorable outcomes. A procalcitonin level ≥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 ≥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 ≥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.

참고자료

· 없음