| Title |
Biomarker kinetics in the prediction of VAP diagnosis: results from the BioVAP study
|
|---|---|
| Published in |
Annals of Intensive Care, April 2016
|
| DOI | 10.1186/s13613-016-0134-8 |
| Pubmed ID | |
| Authors |
Pedro Póvoa, Ignacio Martin-Loeches, Paula Ramirez, Lieuwe D. Bos, Mariano Esperatti, Joana Silvestre, Gisela Gili, Gema Goma, Eugenio Berlanga, Mateu Espasa, Elsa Gonçalves, Antoni Torres, Antonio Artigas |
| Abstract |
Prediction of diagnosis of ventilator-associated pneumonia (VAP) remains difficult. Our aim was to assess the value of biomarker kinetics in VAP prediction. We performed a prospective, multicenter, observational study to evaluate predictive accuracy of biomarker kinetics, namely C-reactive protein (CRP), procalcitonin (PCT), mid-region fragment of pro-adrenomedullin (MR-proADM), for VAP management in 211 patients receiving mechanical ventilation for >72 h. For the present analysis, we assessed all (N = 138) mechanically ventilated patients without an infection at admission. The kinetics of each variable, from day 1 to day 6 of mechanical ventilation, was assessed with each variable's slopes (rate of biomarker change per day), highest level and maximum amplitude of variation (Δ (max)). A total of 35 patients (25.4 %) developed a VAP and were compared with 70 non-infected controls (50.7 %). We excluded 33 patients (23.9 %) who developed a non-VAP nosocomial infection. Among the studied biomarkers, CRP and CRP ratio showed the best performance in VAP prediction. The slope of CRP change over time (adjusted odds ratio [aOR] 1.624, confidence interval [CI]95% [1.206, 2.189], p = 0.001), the highest CRP ratio concentration (aOR 1.202, CI95% [1.061, 1.363], p = 0.004) and Δ (max) CRP (aOR 1.139, CI95% [1.039, 1.248], p = 0.006), during the first 6 days of mechanical ventilation, were all significantly associated with VAP development. Both PCT and MR-proADM showed a poor predictive performance as well as temperature and white cell count. Our results suggest that in patients under mechanical ventilation, daily CRP monitoring was useful in VAP prediction. Trial registration NCT02078999. |
Mendeley readers
The data shown below were compiled from readership statistics for 94 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 1% |
| Unknown | 93 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 10 | 11% |
| Student > Bachelor | 10 | 11% |
| Other | 9 | 10% |
| Student > Master | 8 | 9% |
| Student > Ph. D. Student | 7 | 7% |
| Other | 25 | 27% |
| Unknown | 25 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 49 | 52% |
| Biochemistry, Genetics and Molecular Biology | 5 | 5% |
| Nursing and Health Professions | 3 | 3% |
| Immunology and Microbiology | 3 | 3% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 2% |
| Other | 6 | 6% |
| Unknown | 26 | 28% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 April 2016.
All research outputs
#20,320,000
of 22,862,742 outputs
Outputs from Annals of Intensive Care
#955
of 1,043 outputs
Outputs of similar age
#254,733
of 300,620 outputs
Outputs of similar age from Annals of Intensive Care
#27
of 28 outputs
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