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Role of C-reactive Protein and Tumor Necrosis Factor-Alpha in Differentiating between Ventilator-Associated Pneumonia and Systemic Inflammatory Response Syndrome without Infectious Etiology.
| Content Provider | Europe PMC |
|---|---|
| Author | Salehifar, Ebrahim Tavakolian Arjmand, Shima Aliyali, Masoud Abedi, Siavash Sharifpour, Ali Alipour, Abbas Ala, Shahram Eslami, Gohar Bozorgi, Farzad Mahdavi, Mohammad Reza Walley, Keith R. |
| Copyright Year | 2016 |
| Abstract | Background:Differential diagnosis of systemic inflammatory response syndrome (SIRS) with or without infectious cause is critically important in terms of initiating antimicrobial agents in case of infectious etiology such as ventilator-associated pneumonia (VAP). The aim of this study was to determine the diagnostic and prognostic roles of C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α) in differentiating between ventilator-associated pneumonia and SIRS without infectious etiology.Materials and Methods:In this prospective observational study, 91 adult intensive care unit (ICU) patients were enrolled. According to established diagnostic criteria, they were classified into three groups of “non-SIRS non-VAP”, “SIRS non-VAP” and “SIRS-VAP”. Serum CRP and TNF-α were measured on days 1, 3 and 7 of the study and compared using repeated measures ANOVA.Results:With respect to diagnosis, there was no significant difference in the values of these biomarkers between groups (P>0.05). There was no statistically significant “time trend” for C-reactive protein and TNF-α (P>0.05). Considering both group effect and Time effect, the changes were not significantly different for CRP (P= 0.86) and TNF-α (P=0.69). In contrast, the clinical score and the clinical pulmonary infection score (CPIS) ≥ 6, had 100% specificity for diagnosing VAP. With respect to prognosis, only an unchanged or decreasing TNF-α from day 1 to day 3 was marginally associated with 28-day survival. However, day 1 and day 3 acute physiology and chronic health evaluation II (APACHE II) scores were highly associated with 28-day survival.Conclusion:Unlike clinical scoring system including CPIS and APACHE II, TNF-α and CRP levels were not useful as diagnostic or prognostic biomarkers for differentiating between SIRS with VAP etiology and SIRS without infectious etiology. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC5410116&blobtype=pdf |
| ISSN | 17350344 |
| Journal | Tanaffos |
| Volume Number | 15 |
| PubMed Central reference number | PMC5410116 |
| Issue Number | 4 |
| PubMed reference number | 28469676 |
| e-ISSN | 23453729 |
| Language | English |
| Publisher | National Research Institute of Tuberculosis and Lung Disease |
| Publisher Date | 2016-01-01 |
| Access Restriction | Open |
| Rights License | This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright© 2016 National Research Institute of Tuberculosis and Lung Disease |
| Subject Keyword | Biomarker Infection Inflammation Systemic inflammatory response syndrome Ventilator-Associated Pneumonia |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Critical Care and Intensive Care Medicine |
