LAUSR

Purpose: Ventilator‐associated tracheobronchitis (VAT) has been suggested as an intermediate process between tracheobronchial colonization and ventilator‐associated pneumonia (VAP) in patients receiving mechanical ventilation. The aim of this study was to evaluate the ability of C‐reactive protein (CRP) and procalcitonin (PCT) to differentiate between VAT and VAP. Methods: Pre‐planned analysis of the prospective multinational TAVeM database, performed on 2960 patients receiving mechanical ventilation for >48 h, including 689 patients with VA‐LRTI. Patients with the diagnosis of VAT or VAP microbiologically documented and with one measurement of CRP and/or PCT on the day of diagnosis were included. Results: Four hundred and four patients (mean age 63 years, 298 men, ICU mortality 40%) were studied, 207 with VAT and 197 with VAP. On the day of infection diagnosis, the median CRP was elevated in both groups but significantly higher in VAP (18 mg/dL vs. 14 mg/dL, p = .001). Median PCT was also significantly higher in VAP (2.1 ng/dL vs. 0.64 ng/d L, p < .001). Both biomarkers could not help distinguish between VAT and VAP. Conclusion: Although PCT and CRP presented lower values in VAT as compared to VAP, there was a marked overlap of both biomarkers values in both VA‐LRTI not allowing adequate discrimination.