Abstract
Background: Measurement of prohormones representing different pathophysiological pathways could enhance risk stratification in SCAP pts. The aim of the study was to investigate procalcitonin(PCT),adrenomedullin(AMD),copeptin (CP),B-type natriuretic peptide (BNP-32) levels in ICU SCAP pts and their relationship with in-hospital outcomes (in-hospital mortality(IHM),length of in-hospital stay(LOS),duration of ICU stay),disease specific complications,need for invasive mechanical ventilation(IMV) and vasopressor support(VS) Methods: 20 ICU pts with proven SCAP CURB-65 class 3,4 were enrolled to the study.Serum PCT,AMD, CP,BNP-32 values were measured within the 24 hours after admission. Results: Increasing CAP severity was associated with increased PCT values(r=0,74;p=0,05).PCT in CURB-65 3 and 4 class pts was [median]0,73 vs 5,94 ng/ml,respectively(p=0,03).CP levels on admission appeared to be higher in CURB-65 4th class pts vs the 3rd class pts -74,8 vs 47,6 pg/ml,respectively(p=0,03).PCT values demonstrated statistically significant correlation with IHM (r=0,74;p=0,005),were higher in non-survivors than those in survivors[5,94 vs 0,73 ng/ml,p=0,01].PCT and CP values correlated with need for VS (r=0,74;p=0,0005 and r=0,54;p=0,02) and showed higher concentrations in pts requiring VS compared with those with stable haemodynamics [102 vs 0,73 ng/ml, p=0,01] and [74,8 vs 47,6 pg/ml, p=0,03].AMD levels on ICU admission were associated with need for IMV (r=0,47; p=0,04).BNP-32 values correlated with LOS (r=0,56; p=0,02),PCT - with duration of ICU stay(r=0,81; p=0,001). Conclusion: PCT and CP appeared to be the most reliable prognostic biomarkers in ICU pts with SCAP.
- © 2012 ERS
