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首页> 外文期刊>Journal of Clinical and Diagnostic Research >C-Reactive Protein Kinetics in Prognosis of Ventilator-Associated Pneumonia
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C-Reactive Protein Kinetics in Prognosis of Ventilator-Associated Pneumonia

机译：呼吸机相关肺炎预后的C反应蛋白动力学

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Prognosis of Ventilator Associated Pneumonia (VAP) is commonly predicted by on-site assessment of clinical, haematological and biochemical parameters. Sequential measurement of C-Reactive Protein (CRP) which is one of the low-cost biomarkers could be useful in the early identification of poor outcome of VAP.Aim: To assess the prognostic value of progressive CRP levels in patients with VAP and compare with non-VAP group of ventilated patients.Materials and Methods: This was a prospective observational cohort study at medico-surgical ICU between November 2017 and October 2018. The patients on mechanical ventilator for more than 48 hours were divided into VAP (n=27) and non-VAP group (n=38). VAP was considered based on modified Clinical Pulmonary Infection Score (CPIS) more than 6 along with microbiological evidence from Tracheal aspirate or Bronchoalveolar lavage fluid with consolidation in Chest X-ray. Study subjects were monitored for the development of VAP. CRP measurements were done daily for the first 7 days then on 14~(th) day. The evolution of mean CRP concentration throughout the course of VAP and non-VAP were analysed and compared between survivors and non-survivors.Results: Mean CRP level of VAP patients on the day of diagnosis was almost similar to non-VAP cohort. The mean CRP of non-survivor groups of both VAP and non-VAP patients had shown a gradual increase after day 4. However, the mean CRP after day 4, in the survivor group of both VAP and non-VAP showed either decreasing or unchanged trends.Conclusion: It was evident that the dynamics of the CRP levels in patients with VAP can be used to assess the effects of the therapy for a better outcome.
机译：呼吸机相关肺炎（VAP）的预后通常通过现场评估临床，血液学和生物化学参数进行预测。作为低成本生物标志物之一的C反应蛋白（CRP）的顺序测量可用于早期鉴定VAP的差的差异。目的：评估VAP患者逐步CRP水平的预后价值并与非VAP通风患者组比较。材料和方法：这是2017年11月至2018年11月期间医疗ICU的前瞻性观察队列研究。机械通风机上的患者将分为48小时以上VAP（n = 27）和非VAP组（n = 38）。基于修饰的临床肺部感染评分（CPI）的临床肺部感染评分（CPI）以及来自气管插入或支气管肺泡灌洗液的微生物诊断，具有来自胸部X射线的固结的微生物学证据。监测研究受试者的VAP发展。在14〜（th）日，每天每天进行CRP测量。在幸存者和非幸存者之间进行分析并比较了在整个VAP和非VAP过程中的平均CRP浓度的演变。结果：诊断当天的VAP患者的平均CRP水平几乎类似于非VAP队列。 VAP和非VAP患者的非幸存者组的平均CRP在第4天后逐渐增加。然而，第4天的平均CRP，在VAP和非VAP的幸存者组中显示出减少或不变趋势。结论：显然，VAP患者CRP水平的动态可用于评估治疗的影响更好的结果。

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