Afficher la notice abrégée

dc.creatorParmentier-Decrucq, E.en
dc.creatorNseir, S.en
dc.creatorMakris, D.en
dc.creatorDesrousseaux, B.en
dc.creatorSoudan, B.en
dc.creatorFavory, R.en
dc.creatorMathieu, D.en
dc.date.accessioned2015-11-23T10:45:02Z
dc.date.available2015-11-23T10:45:02Z
dc.date.issued2014
dc.identifier.issn0375-9393
dc.identifier.urihttp://hdl.handle.net/11615/32050
dc.description.abstractBackground. Undernutrition causes a reduction of body-fat mass and a decrease in the circulating concentration of leptin which impairs the production of proinflammatory cytokines and increases the incidence of infectious diseases. The main objective of this study was to determine whether leptin deficiency is a risk factor for ventilator-associated pneumonia (VAP). Methods. This prospective observational case-control study was conducted in a university ICU during a 2-year period. Patients with VAP (cases) were matched (1:1) to patients without VAP (controls) according to all the following criteria: age, gender, SAPS II, and duration of ICU stay before VAP occurrence. In all patients leptin, C-reactive protein (CRP) and procalcitonin (PCT) were measured at ICU admission, and twice a week. In addition, in cases, leptin, CRP and PCT were also measured on the day of VAP diagnosis. Results. Eighty-six cases were matched with 86 controls. No significant difference was found in leptin and PCT levels between cases and controls. CRP level was significantly higher on the day of VAP in cases compared with controls (99 vs. 48 mg/L, P=0.001). Combination of CRP-leptin (CRP >= 78 mg/L and leptin >= 6.2 ng/mL on the day of VAP) was significantly (P=0.009) associated with VAP in univariate analysis. Multivariate analysis identified the combination of CRP-leptin (OR [95% CI] 3.08 [1.18-8.04], P=0.003), LOD score (1.27 [1.08-1.48], P=0.003), neuromuscular-blockers use (6.6 [2.03-21.7], P=0.002), and reintubation (3.3 [1.14-9.6], P=0.027) as independent risk factors for VAP. Conclusion. In our study, leptin level was not associated with VAP occurrence. Further studies are needed to confirm our results, and to define the exact inflammatory role of leptin, and its interest as a biomarker in ICU patients.en
dc.sourceMinerva Anestesiologicaen
dc.source.uri<Go to ISI>://WOS:000332140600008
dc.subjectPneumoniaen
dc.subjectventilator-associateden
dc.subjectLeptinen
dc.subjectBiological markersen
dc.subjectINTENSIVE-CARE-UNITen
dc.subjectCRITICALLY-ILL PATIENTSen
dc.subjectGRAM-NEGATIVE PNEUMONIAen
dc.subjectC-REACTIVE PROTEINen
dc.subjectNOSOCOMIAL PNEUMONIAen
dc.subjectRISK-FACTORSen
dc.subjectHOST-DEFENSEen
dc.subjectPNEUMOCOCCAL PNEUMONIAen
dc.subjectMECHANICAL VENTILATIONen
dc.subjectATTRIBUTABLE MORTALITYen
dc.subjectAnesthesiologyen
dc.subjectCritical Care Medicineen
dc.titleAccuracy of leptin serum level in diagnosing ventilator-associated pneumonia: a case-control studyen
dc.typejournalArticleen


Fichier(s) constituant ce document

FichiersTailleFormatVue

Il n'y a pas de fichiers associés à ce document.

Ce document figure dans la(les) collection(s) suivante(s)

Afficher la notice abrégée