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Biomarkers kinetics in the assessment of ventilator-associated pneumonia response to antibiotics - results from the BioVAP study.
Póvoa, Pedro; Martin-Loeches, Ignacio; Ramirez, Paula; Bos, Lieuwe D; Esperatti, Mariano; Silvestre, Joana; Gili, Gisela; Goma, Gemma; Berlanga, Eugenio; Espasa, Mateu; Gonçalves, Elsa; Torres, Antoni; Artigas, Antonio.
Afiliación
  • Póvoa P; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School, CEDOC, New University of Lisbon, Lisbon, Portugal. Electronic address: povoap@netcabo.pt.
  • Martin-Loeches I; Critical Care Center, Sabadell Hospital, Corporación Sanitaria Universitaria Parc Taulí, Universitat Autonoma de Barcelona, Sabadell, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Spain. Electronic address: drmartinloeches@gmail.com.
  • Ramirez P; CIBER de Enfermedades Respiratorias (CIBERES), Spain; Intensive Care Unit, University Hospital La Fe, Valencia, Spain. Electronic address: ramirez_pau@gva.es.
  • Bos LD; Department of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: lieuwe.bos@gmail.com.
  • Esperatti M; CIBER de Enfermedades Respiratorias (CIBERES), Spain; Intensive Care Unit, Hospital Privado de Comunidad, Mar del Plata, Argentina. Electronic address: marianoesperatti@gmail.com.
  • Silvestre J; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School, CEDOC, New University of Lisbon, Lisbon, Portugal. Electronic address: joanapsilvestre@gmail.com.
  • Gili G; Critical Care Center, Sabadell Hospital, Corporación Sanitaria Universitaria Parc Taulí, Universitat Autonoma de Barcelona, Sabadell, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Spain. Electronic address: Gisela.gili@vhir.org.
  • Goma G; Critical Care Center, Sabadell Hospital, Corporación Sanitaria Universitaria Parc Taulí, Universitat Autonoma de Barcelona, Sabadell, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Spain. Electronic address: ggoma@tauli.cat.
  • Berlanga E; Laboratory Department, UDIAT, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Spain. Electronic address: eberlanga@tauli.cat.
  • Espasa M; Laboratory Department, UDIAT, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Spain. Electronic address: mespasa@tauli.cat.
  • Gonçalves E; NOVA Medical School, CEDOC, New University of Lisbon, Lisbon, Portugal; Microbiology Department, Egas Moniz Hospital, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal. Electronic address: elsa.a.goncalves@sapo.pt.
  • Torres A; CIBER de Enfermedades Respiratorias (CIBERES), Spain; Respiratory Disease Department, Hospital Clínic i Provincial de Barcelona, IDIBAPS, Barcelona, Spain. Electronic address: atorres@ub.edu.
  • Artigas A; Critical Care Center, Sabadell Hospital, Corporación Sanitaria Universitaria Parc Taulí, Universitat Autonoma de Barcelona, Sabadell, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Spain. Electronic address: aartigas@tauli.cat.
J Crit Care ; 41: 91-97, 2017 10.
Article en En | MEDLINE | ID: mdl-28502892
PURPOSE: Our aim was to evaluate the role of biomarker kinetics in the assessment of ventilator-associated pneumonia (VAP) response to antibiotics. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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 - NCT02078999; registered 3 August 2012).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Proteína C-Reactiva / Calcitonina / Neumonía Asociada al Ventilador / Adrenomedulina / Antibacterianos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Proteína C-Reactiva / Calcitonina / Neumonía Asociada al Ventilador / Adrenomedulina / Antibacterianos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos