Elevations in procalcitonin but not C-reactive protein are associated with pneumonia after cardiopulmonary resuscitation

• Published in: Resuscitation Vol. 53; no. 2; pp. 167 - 170
• Main Authors: Oppert, Michael, Reinicke, Albrecht, Müller, Christian, Barckow, Detlev, Frei, Ulrich, Eckardt, Kai-Uwe
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.05.2002; Elsevier
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Body Temperature; C-Reactive Protein - metabolism; Calcitonin - blood; Calcitonin Gene-Related Peptide; Cardiac arrest; Cardiopulmonary Resuscitation - adverse effects; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Heart Arrest - therapy; Humans; Infection; Inflammatory response; Intensive care medicine; Medical sciences; Middle Aged; Out of hospital CPR; Pneumonia - blood; Pneumonia - diagnosis; Pneumonia - etiology; Prospective Studies; Protein Precursors - blood; Respiration, Artificial - adverse effects; Sensitivity and Specificity; Time Factors; Infection; CPR, cardiopulmonary resuscitation; ICU, intensive care unit; Cardiac arrest; VAP, ventilator associated pneumonia; WBC, white blood cell count; Out of hospital CPR; Inflammatory response; CXR, chest radiograph; PCT, procalcitonin; CrP, C-reactive protein; Human; Lung disease; Cardiocirculatory arrest; Pneumonia; Respiratory disease; Procalcitonin; Biological marker; Cardiovascular disease; Cardiopulmonary; Inflammation; Systemic; Adult; Complication; Out of hospital; Diagnosis; C reactive protein; Resuscitation
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/S0300-9572(02)00008-4

A possible diagnostic role of procalcitonin (PCT) as a marker for ventilator associated pneumonia (VAP) in patients with an already triggered acute phase response after successful cardiopulmonary resuscitation (CPR) was investigated. In 28 patients with return of spontaneous circulation (ROSC) after out of hospital CPR, measurements of PCT, C-reactive protein (CrP), white blood cell count (WBC) and body temperature were compared with the clinical course of the patients. In this setting, PCT was the only marker to differentiate between patients with and without VAP (median value on day 1, 6.0 vs. 0.5 ng/ml; P<0.001). Using a cut off value of 1 ng/ml during the first 7 days after ROSC PCT had a sensitivity of 100% and a specificity of 75% to indicate VAP. PCT was elevated a median of 2 days earlier than the clinical diagnosis of VAP. Elevations in PCT can, therefore, indicate bacterial complications in cardiac arrest patients with a non-infectious acute phase response.