Serum procalcitonin as an early inflammatory marker in pediatric ventilator-associated pneumonia: A prospective observational study
Background: Delayed diagnosis of ventilator-associated pneumonia (VAP) in pediatric patients is associated with accentuated risk of morbidities and mortality. Early diagnosis of VAP is challenging. Serum procalcitonin has been proposed as a promising inflammatory marker for the early diagnosis of VA...
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doaj-37f515ba7c2f43668f3e465d9ae241b12021-10-07T05:34:08ZengWolters Kluwer Medknow PublicationsJournal of Pediatric Critical Care2349-65922455-70992021-01-018522923310.4103/jpcc.jpcc_55_21Serum procalcitonin as an early inflammatory marker in pediatric ventilator-associated pneumonia: A prospective observational studyDevki NandanManju NimeshSushil KumarLucky ManikJ SudarshanNandini DuggalBackground: Delayed diagnosis of ventilator-associated pneumonia (VAP) in pediatric patients is associated with accentuated risk of morbidities and mortality. Early diagnosis of VAP is challenging. Serum procalcitonin has been proposed as a promising inflammatory marker for the early diagnosis of VAP, but there is a lack of sufficient evidence for the use of serum procalcitonin for early diagnosis of VAP in children. The present study was conducted to determine the role of serum procalcitonin as an early inflammatory marker for an early and provisional diagnosis of VAP among clinically suspected VAP patients in pediatric intensive care unit settings. Subjects and Methods: Seventy-nine pediatric patients (age: 1 month–18 years) with suspected VAP (Simplified Clinical Pulmonary Infection Score >6) were prospectively evaluated with quantitative bronchoalveolar lavage cultures and simultaneously tested for serum procalcitonin levels. Two groups were identified based on culture results and comparatively evaluated for procalcitonin levels, its diagnostic efficacy, antibiotic usage patterns, and mechanical ventilation duration. Results: The VAP group had 39 patients, and the non-VAP group had 40 patients. Thirty-two (82%) patients in the VAP group had a procalcitonin value ≥10 ng/ml as against 10 (25%) from the non-VAP group. Two (5.1%) patients in the VAP group had procalcitonin levels ≤1 ng/ml as against 21 (52.5%) patients in the non-VAP group. The receiver operating characteristic area under curve for procalcitonin with a cutoff >10 ng/ml was 0.785 (95% confidence interval = 0.678–0.870) with a sensitivity of 82.05% and specificity of 75%. Conclusions: Serum procalcitonin is a reliable biomarker to augment the provisional diagnosis of VAP in clinically suspected cases. Such diagnosis may help in an early institution of definitive therapy for VAP.http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2021;volume=8;issue=5;spage=229;epage=233;aulast=Nandanbronchoalveolar lavageserum biomarkerserum procalcitoninsimplified clinical pulmonary infection scoreventilator-associated pneumonia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Devki Nandan Manju Nimesh Sushil Kumar Lucky Manik J Sudarshan Nandini Duggal |
spellingShingle |
Devki Nandan Manju Nimesh Sushil Kumar Lucky Manik J Sudarshan Nandini Duggal Serum procalcitonin as an early inflammatory marker in pediatric ventilator-associated pneumonia: A prospective observational study Journal of Pediatric Critical Care bronchoalveolar lavage serum biomarker serum procalcitonin simplified clinical pulmonary infection score ventilator-associated pneumonia |
author_facet |
Devki Nandan Manju Nimesh Sushil Kumar Lucky Manik J Sudarshan Nandini Duggal |
author_sort |
Devki Nandan |
title |
Serum procalcitonin as an early inflammatory marker in pediatric ventilator-associated pneumonia: A prospective observational study |
title_short |
Serum procalcitonin as an early inflammatory marker in pediatric ventilator-associated pneumonia: A prospective observational study |
title_full |
Serum procalcitonin as an early inflammatory marker in pediatric ventilator-associated pneumonia: A prospective observational study |
title_fullStr |
Serum procalcitonin as an early inflammatory marker in pediatric ventilator-associated pneumonia: A prospective observational study |
title_full_unstemmed |
Serum procalcitonin as an early inflammatory marker in pediatric ventilator-associated pneumonia: A prospective observational study |
title_sort |
serum procalcitonin as an early inflammatory marker in pediatric ventilator-associated pneumonia: a prospective observational study |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of Pediatric Critical Care |
issn |
2349-6592 2455-7099 |
publishDate |
2021-01-01 |
description |
Background: Delayed diagnosis of ventilator-associated pneumonia (VAP) in pediatric patients is associated with accentuated risk of morbidities and mortality. Early diagnosis of VAP is challenging. Serum procalcitonin has been proposed as a promising inflammatory marker for the early diagnosis of VAP, but there is a lack of sufficient evidence for the use of serum procalcitonin for early diagnosis of VAP in children. The present study was conducted to determine the role of serum procalcitonin as an early inflammatory marker for an early and provisional diagnosis of VAP among clinically suspected VAP patients in pediatric intensive care unit settings.
Subjects and Methods: Seventy-nine pediatric patients (age: 1 month–18 years) with suspected VAP (Simplified Clinical Pulmonary Infection Score >6) were prospectively evaluated with quantitative bronchoalveolar lavage cultures and simultaneously tested for serum procalcitonin levels. Two groups were identified based on culture results and comparatively evaluated for procalcitonin levels, its diagnostic efficacy, antibiotic usage patterns, and mechanical ventilation duration.
Results: The VAP group had 39 patients, and the non-VAP group had 40 patients. Thirty-two (82%) patients in the VAP group had a procalcitonin value ≥10 ng/ml as against 10 (25%) from the non-VAP group. Two (5.1%) patients in the VAP group had procalcitonin levels ≤1 ng/ml as against 21 (52.5%) patients in the non-VAP group. The receiver operating characteristic area under curve for procalcitonin with a cutoff >10 ng/ml was 0.785 (95% confidence interval = 0.678–0.870) with a sensitivity of 82.05% and specificity of 75%.
Conclusions: Serum procalcitonin is a reliable biomarker to augment the provisional diagnosis of VAP in clinically suspected cases. Such diagnosis may help in an early institution of definitive therapy for VAP. |
topic |
bronchoalveolar lavage serum biomarker serum procalcitonin simplified clinical pulmonary infection score ventilator-associated pneumonia |
url |
http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2021;volume=8;issue=5;spage=229;epage=233;aulast=Nandan |
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