AUTHOR=Ocakli Birsen , Tuncay Eylem , Gungor Sinem , Sertbas Meltem , Adiguzel Nalan , Irmak Ilim , Ciftaslan Goksenoglu Nezihe , Aksoy Emine , Berk Takir Huriye , Yazicioglu Mocin Ozlem , Karakurt Zuhal 

TITLE=Inflammatory Markers in Patients Using Domiciliary Non-invasive Mechanical Ventilation: C Reactive Protein, Procalcitonin, Neutrophil Lymphocyte Ratio

JOURNAL=Frontiers in Public Health

VOLUME=Volume 6 - 2018

YEAR=2018

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2018.00245

DOI=10.3389/fpubh.2018.00245

ISSN=2296-2565

ABSTRACT=Aim: Early identification and treatment of infections in patients using domiciliary noninvasive mechanical ventilation (NIMV) due to the chronic respiratory failure (CRF)  that can reduce hospital admissions. In the study, C-reactive protein (CRP), procalcitonin, and recently used neutrophil lymphocyte ratio (NLR) were assessed together for infection/inflammation.
Methods: Study designed as a retrospective observational cross-sectional study and it was performed in an intensive care unit outpatient clinic in 2016 where patients with NIMV. Patients who came to outpatient clinic and researched for dyspnoea, increased sputum, increased prothrombin, hemogram and procalcitonin for serum CRP, NLO, PLT/MPV were enrolled into the study. Attacks and stabil clinics, demographic characteristics, co-morbid diseases, respiratory symptoms, hemogram, biochemistry, CRP, procalcitonin values were recorded from patient files. The descriptive statistics and CRP, NLR, and procalcitonin values were done. 
Results: During the study period, 49 patients (Women, N=24) with chronic obstructive pulmonary disease (COPD, N= 24) and restrictive pulmonary disease (OHS, N= 15 and interstitial lung diseases, N=10) with having 3 inflammatory markers were included in the study. Their mean age was 67 (SD±12). Stabil/attack rate was 41/8 and were not required hospitalization and in seven days 1/3, a total 4 patients hospitalized respectively. CRP, NLR, and PLT/MPV values were similar in patients' who had sputum purulence, increase in dyspnea and sputum, but procalcitonin was significantly higher in patients with attack. Procalcitonin was not correlated with CRP, NLO and PLT/MPV.
Conclusions: Patients with CRF have similar level of CRP and NLR during stable state and clinical attack state and procalcitonin may be a better marker for antibiotherapy decisions in advanced chronic inflammatory diseases.