procalcitonin and c-reactive protein levels at admission as predictors of duration of acute brain dysfunction in critically ill patients原降钙素和c反应蛋白水平的入学时间的预测危重患者急性脑功能障碍.pdfVIP

McGrane et al. Critical Care 2011, 15:R78 /content/15/2/R78 RESEARCH Open Access Procalcitonin and C-reactive protein levels at admission as predictors of duration of acute brain dysfunction in critically ill patients 1 2,3 4 4 5 Stuart McGrane , Timothy D Girard , Jennifer L Thompson , Ayumi K Shintani , Alison Woodworth , E Wesley Ely2,3, Pratik P Pandharipande1,6* Abstract Introduction: Non-intensive care unit (ICU) cohorts have shown an association between inflammatory disturbances and delirium, though these relationships have not been studied in critically ill patients. This study sought to investigate the relationship between two inflammatory biomarkers, procalcitonin and C-reactive protein (CRP), and duration of acute brain dysfunction in ventilated patients. Methods: Patients enrolled in the Maximizing Efficacy of Targeted Sedation and Reducing Neurological Dysfunction (MENDS) trial were assessed daily for delirium using the Confusion Assessment Method-ICU. Plasma levels of procalcitonin and CRP were obtained within 24 hours of enrollment. Proportional odds logistic regression was used to examine the association between procalcitonin and CRP separately with delirium/coma-free days, adjusting for age, acute physiology score (APS) of the Acute Physiology And Chronic Health Evaluation (APACHE) II, sedation group (dexmedetomidine vs. lorazepam), and sepsis. Secondary analyses examined the association of these markers with other organ dysfunctions and 28-day survival. Results: Eighty-seven patients were included in this analysis. The median age of the patients was 60 years with APACHE II scores of 28; 68% had sepsis within 48 hours of admission. Higher levels of procalcitonin we