Biomarkers kinetics in the assessment of ventilator-associated pneumonia response to antibiotics - results from the BioVAP study

Journal of Critical Care
Pedro PóvoaAntonio Artigas

Abstract

Our aim was to evaluate the role of biomarker kinetics in the assessment of ventilator-associated pneumonia (VAP) response to antibiotics. We performed a prospective, multicenter, observational study to evaluate in 37 microbiologically documented VAP, the kinetics of C-reactive protein (CRP), procalcitonin (PCT), mid-region fragment of pro-adrenomedullin (MR-proADM). The kinetics of each variable, from day 1 to 6 of therapy, was assessed with a time dependent analysis comparing survivors and non-survivors. During the study period kinetics of CRP as well as its relative changes, CRP-ratio, was significantly different between survivors and non-survivors (p=0.026 and p=0.005, respectively). On day 4 of antibiotic therapy, CRP of survivors was 47% of the initial value while it was 96% in non-survivors. The kinetics of other studied variables did not distinguish between survivors and non-survivors. In survivors the bacterial load also decreased markedly. Adequate initial antibiotic therapy was associated with lower mortality (p=0.025) and faster CRP decrease (p=0.029). C-reactive protein kinetics can be used to identify VAP patients with poor outcome as soon as four days after the initiation of treatment. (Trial registration - NCT02...Continue Reading

Associated Clinical Trials

Mar 5, 2014·Antonio Artigas Raventós

Citations

Aug 2, 2017·Current Opinion in Critical Care·Jorge I F SalluhPedro Póvoa
Nov 18, 2017·Expert Review of Molecular Diagnostics·Justin J Choi, Matthew W McCarthy
Jul 1, 2020·Critical Care : the Official Journal of the Critical Care Forum·Rafael ZaragozaIgnacio Martín-Loeches
Jun 16, 2019·Critical Care : the Official Journal of the Critical Care Forum·Sean Keane, Ignacio Martin-Loeches
Feb 10, 2021·Clinical Pharmacology and Therapeutics·Linda B S AulinJ G Coen van Hasselt

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