ArticleIntensive care medicine2010
Microbiogical data, but not procalcitonin improve the accuracy of the clinical pulmonary infection score.
Article in Intensive care medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Biomarkers in lower respiratory tract samples in the diagnosis of ventilator-associated pneumonia: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2025Pooled it
- Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care.BMC pulmonary medicine · 2021Pooled it
- Diagnosis of ventilator-associated pneumonia in critically ill adult patients-a systematic review and meta-analysis.Intensive care medicine · 2020Pooled it
- Pooled it
- Biomarker-guided antibiotic stewardship in suspected ventilator-associated pneumonia (VAPrapid2): a randomised controlled trial and process evaluation.The Lancet. Respiratory medicine · 2020Trial
- The Clinical Pulmonary Infection Score Combined with Procalcitonin and Lung Ultrasound (CPIS-PLUS), a Good Tool for Ventilator Associated Pneumonia Early Diagnosis in Pediatrics.Children (Basel, Switzerland) · 2024Article
- Guidelines for the Use of Procalcitonin for Rational Use of Antibiotics.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Analysis of risk factors for early-onset ventilator-associated pneumonia in a neurosurgical intensive care unit.BMC infectious diseases · 2022Article
- Ventilator-associated pneumonia in neonates: the role of point of care lung ultrasound.European journal of pediatrics · 2021Article
- Gradient diffusion antibiogram used directly on bronchial aspirates for a rapid diagnosis of ventilator-associated pneumonia.Antimicrobial resistance and infection control · 2019Article
- Lung ultrasound for diagnosis and monitoring of ventilator-associated pneumonia.Annals of translational medicine · 2018Review
- Procalcitonin as a biomarker in equine chronic pneumopathies.BMC veterinary research · 2016Article
- Biomarker kinetics in the prediction of VAP diagnosis: results from the BioVAP study.Annals of intensive care · 2016Article
- ATS Core Curriculum 2016. Part IV. Adult Pulmonary Medicine Core Curriculum.Annals of the American Thoracic Society · 2016Article
- Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?World journal of experimental medicine · 2015Review
- Use of rapid diagnostic techniques in ICU patients with infections.BMC infectious diseases · 2014Review
- [Use of biomarkers in sepsis. Update and perspectives].Der Anaesthesist · 2014Review
- Procalcitonin biomarker kinetics fails to predict treatment response in perioperative abdominal infection with septic shock.Critical care (London, England) · 2013Observational
- The evolving concepts of haemodynamic support: from pulmonary artery catheter to echocardiography and theragnostics.Current cardiology reviews · 2011Review
- Diagnostic use of serum procalcitonin levels in pulmonary aspiration syndromes.Critical care medicine · 2011Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveEarly and adequate treatment of ventilator-associated pneumonia (VAP) is mandatory to improve the outcome. The aim of this study was to evaluate, in medical ICU patients, the respective and combined impact of the Clinical Pulmonary Infection Score (CPIS), broncho-alveolar lavage (BAL) gram staining, endotracheal aspirate and a biomarker (procalcitonin) for the early diagnosis of VAP.
designProspective, observational study
settingA medical intensive care unit in a teaching hospital. PATIENTS: Over an 8-month period, we prospectively included 57 patients suspected of having 86 episodes of VAP.
interventionThe day of suspicion, a BAL as well as alveolar and serum procalcitonin determinations and evaluation of CPIS were performed. MEASUREMENTS AND MAIN
resultsOf 86 BAL performed, 48 were considered positive (cutoff of 10(4) cfu ml(-1)). We found no differences in alveolar or serum procalcitonin between VAP and non-VAP patients. Including procalcitonin in the CPIS score did not increase its accuracy (55%) for the diagnosis of VAP. The best tests to predict VAP were modified CPIS (threshold at 6) combined with microbiological data. Indeed, both routinely twice weekly performed endotracheal aspiration at a threshold of 10(5) cfu ml(-1) and BAL gram staining improved pre-test diagnostic accuracy of VAP (77 and 66%, respectively).
conclusionThis study showed that alveolar procalcitonin performed by BAL does not help the clinician to identify VAP. It confirmed that serum procalcitonin is not an accurate marker of VAP. In contrast, microbiological resources available at the time of VAP suspicion (BAL gram staining, last available endotracheal aspirate) combined or not with CPIS are helpful in distinguishing VAP diagnosed by BAL from patients with a negative BAL.
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