Procalcitonin in the Assessment of Ventilator Associated Pneumonia : A Systematic Review

BACKGROUND: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infection, associated with considerable mortality and morbidity in critically ill patients; however, its diagnosis and management remain challenging since clinical assessment is often poorly reliable. The aim of this systematic review was to evaluate the role of PCT in the diagnosis and management of critical ill patients affected by VAP.

METHODS: We performed a systematic review of the evidence published over the last 10 years and currently available in medical literature search databases (Pubmed, Embase, Web of Knowledge, Cochrane Libraries) and searching clinical trial registries. We regarded as predefined outcomes the role of PCT in diagnosis, therapeutic monitoring, antibiotic discontinuation and prognosis. The Open Science Framework Registration number was doi.org/10.17605/OSF.

IO/ZGFKQ RESULTS: 761 articles were retrieved and a total of 18 studies (n° of patients = 1774) were selected and analyzed according to inclusion criteria. In this 2020 update, the systematic review showed that currently, conflicting and inconclusive data are available about the role of PCT in the diagnosis of VAP and in the prediction (i) of the efficacy of antibiotic therapy, and (ii) of the clinical outcome. These studies, instead, seem to agree on the utility of PCT in the management of antibiotic therapy discontinuation.

CONCLUSIONS: Currently there is insufficient evidence to support the role of PCT in the routine assessment of patients with VAP. The value of the results published appears to be limited by the deep methodological differences that characterize the various studies available at the present being.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:1323

Enthalten in:

Advances in experimental medicine and biology - 1323(2021) vom: 08., Seite 103-114

Sprache:

Englisch

Beteiligte Personen:

Alessandri, Francesco [VerfasserIn]
Pugliese, Francesco [VerfasserIn]
Angeletti, Silvia [VerfasserIn]
Ciccozzi, Massimo [VerfasserIn]
Russo, Alessandro [VerfasserIn]
Mastroianni, Claudio M [VerfasserIn]
d'Ettorre, Gabriella [VerfasserIn]
Venditti, Mario [VerfasserIn]
Ceccarelli, Giancarlo [VerfasserIn]

Links:

Volltext

Themen:

Anti-Bacterial Agents
Antibiotic stewardship
Antibiotic therapy
Critical care
Driven discontinuation
ICU
Intensive care unit
Journal Article
PCT
Pneumonia
Procalcitonin
Systematic Review
Systematic review
VAP
Ventilator associated pneumonia

Anmerkungen:

Date Completed 14.04.2021

Date Revised 14.04.2021

published: Print

Citation Status MEDLINE

doi:

10.1007/5584_2020_591

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM316007781