Diagnostic utility of serum procalcitonin in ventilator-associated pneumonia in the pediatric intensive care unit.

Abstract

Background: Mechanical ventilation is a respiratory support system that works as a lifesaver for critically sick children in pediatric intensive care units. Ventilator-associated pneumonia (VAP) is a serious infection and one of the most common complications of mechanical ventilation. VAP remains a challenge to pediatricians in diagnosis due to variable clinical criteria and the lack of discriminative diagnostic tests. Delayed VAP diagnosis can lead to increased risk of morbidities and mortality. Objective: To evaluate the diagnostic utility of serum procalcitonin (PCT) in ventilator-associated pneumonia among mechanically ventilated pediatric patients, clinically exhibiting signs of VAP in pediatric intensive care unit. Methods: This is a prospective observational study that was conducted on 165 pediatric patients who were subjected to mechanical ventilation; 80 cases diagnosed with ventilator associated pneumonia (VAP-positive) and 85 cases negative for VAP (VAP-negative). Results: Serum PCT was elevated in VAP-positive group (3.67 ± 2.4 ng/ml) compared to VAP-negative group (1.72 ± 2.43 ng/ml) with statistically significant difference (P<0.001). Conclusion: Serum procalcitonin is a valuable biomarker to be considered in the provisional diagnosis of ventilator-associated pneumonia in pediatric patients on mechanical ventilation that have a suspicion for VAP.