title: Role of combined procalcitonin and lipopolysaccharide-binding protein as prognostic markers of mortality in patients with ventilator-associated pneumonia.
abstract: OBJECTIVE
  to investigate the role of combined Lipopolysaccharide-Binding Protein (LBP) and Procalcitonin (PCT) ) as prognostic marker of mortality in patients with Ventilator-Associated Pneumonia (VAP).
  
  
  METHODS
  this prospective cohort study was held in ICU/HCU of Cipto Mangunkusumo hospital between 2006 to 2007 by taking the subjects consecutively. Thirty five patients with VAP were studied. For analysing the data, chi-square or its alternative Fisher exact test were used. Based on a previous study for evaluation, we used cut off pants of 5 ng/ml and 0.5 ng/ml for PCT and 30 µg/ml and 25 µg/ml for LBP after three-day and seven-day treatment respectively. Receiver operating curve was made to determine the sensitivity and specificity of PCT and LBP as infection markers.
  
  
  RESULTS
  35 patients participated in this study. After three days of therapy, if the level of PCT >5 ng/mL and LBP >30 µg/mL the prognosis would be bad (p<0.05) with a sensitivity of 88.5%, specificity of 53.2% and AUC value 0.69. Poor prognosis was also found if after seven day therapy PCT level was >0.5 ng/mL and LBP level >25 µg/mL (p<0.05) with sensitivity of 96.3%, specificity of 66.7% and AUC value 0.81.
  
  
  CONCLUSIONS
  examination of combined PCT and LBP can be taken as a good prognostic markers to predict mortality in patients with VAP.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. rumende_martin@yahoo.com
authors.forename: Cleopas M
authors.initials: CM
authors.lastname: Rumende
authors.forename: Dinajani
authors.initials: D
authors.lastname: Mahdi
mesh_terms: D000209:Acute-Phase Proteins; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002352:Carrier Proteins / Q000097:blood*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000097:blood / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D012720:Severity of Illness Index; D000099231:Lipopolysaccharide-Binding Protein
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide; D002352:Carrier Proteins; D008562:Membrane Glycoproteins; D011498:Protein Precursors; D000099231:Lipopolysaccharide-Binding Protein; C000606589:CALCA protein, human