Procalcitonin and C-reactive protein kinetics in postoperative pediatric cardiac surgical patients

Procalcitonin and C-reactive protein kinetics in postoperative pediatric cardiac surgical patients

Author Arkader, R. Google Scholar
Troster, E. J. Google Scholar
Abellan, D. M. Google Scholar
Lopes, M. R. Google Scholar
Raiz, R. Google Scholar
Carcillo, J. A. Google Scholar
Okay, T. S. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Univ Pittsburgh
Abstract Objective: To determine the kinetics of procalcitonin (PCT) and C-reactive protein (CRP) concentration after pediatric cardiac surgery with cardiopulmonary bypass.Design: Prospective, clinical cohort study.Setting: A fifteen-bed tertiary-care pediatric intensive care unit.Patients: Fourteen pediatric patients admitted for cardiac surgery.Measurements and Main Results: Serum PCT and CRP were measured before cardiopulmonary bypass (CPB); after CPB; and on the first, second, and third days after surgery by means of immunoluminometry and nephelometry, respectively. Reference values for systemic inflammatory response syndrome are 0.5 to 2.0 ng/mL for PCT and <5 mg/L for CRP. Baseline serum PCT and CRP concentrations were 0.24 +/- 0.13 ng/mL and 4.06 +/- 3.60 mg/L (median 25th percentile-75th percentile), respectively. PCT concentrations increased progressively from the end of CPB (0.62 +/- 0.30 ng/mL), peaked at 24 hours postoperatively (POD1) (0.77 +/- 0.49 ng/mL), and began to decrease at 48 hours or POD2 (0.35 +/- 0.21 ng/mL). CRP increased just after CPB (58.82 +/- 42.23 mg/L) and decreased after 72 hours (7.09 +/- 9.81 mg/L).Conclusion: An increment of both PCT and CRP was observed just after CPB. However, PCT values remained within reference values, whereas CRP concentrations increased significantly after CPB until the third day. These preliminary results suggest that PCT was more effective than CRP to monitor patients with SIRS and a favorable outcome. (C) 2004 Elsevier Inc. All rights reserved.
Keywords cardiopulmonary bypass
systemic inflammatory response
procalcitonin
C-reactive protein
sepsis
Language English
Date 2004-04-01
Published in Journal of Cardiothoracic and Vascular Anesthesia. Philadelphia: W B Saunders Co, v. 18, n. 2, p. 160-165, 2004.
ISSN 1053-0770 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co
Extent 160-165
Origin http://dx.doi.org/10.1053/j.jvca.2004.01.021
Access rights Closed access
Type Article
Web of Science ID WOS:000220941500009
URI http://repositorio.unifesp.br/handle/11600/27700

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