Procalcitonin does discriminate between sepsis and systemic inflammatory response syndrome

Procalcitonin does discriminate between sepsis and systemic inflammatory response syndrome

Author Arkader, R. Google Scholar
Troster, E. J. Google Scholar
Lopes, M. R. Google Scholar
Junior, R. R. Google Scholar
Carcillo, J. A. Google Scholar
Leone, C. Google Scholar
Okay, T. S. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Univ Pittsburgh
Abstract Aims: To evaluate whether procalcitonin ( PCT) and C reactive protein (CRP) are able to discriminate between sepsis and systemic inflammatory response syndrome ( SIRS) in critically ill children.Methods: Prospective, observational study in a paediatric intensive care unit. Kinetics of PCT and CRP were studied in patients undergoing open heart surgery with cardiopulmonary bypass (CPB) ( SIRS model; group I-1) and patients with confirmed bacterial sepsis ( group II).Results: in group I, PCT median concentration was 0.24 ng/ml ( reference value <2.0 ng/ml). There was an increment of PCT concentrations which peaked immediately after CPB ( median 0.58 ng/ml), then decreased to 0.47 ng/ml at 24 h; 0.33 ng/ml at 48 h, and 0.22 ng/ml at 72 h. CRP median concentrations remained high on POD1 (36.6 mg/l) and POD2 (13.0 mg/l). in group II, PCT concentrations were high at admission ( median 9.15 ng/ml) and subsequently decreased in 11/14 patients who progressed favourably ( median 0.31 ng/ml). CRP levels were high in only 11/14 patients at admission. CRP remained high in 13/14 patients at 24 h; in 12/14 at 48 h; and in 10/14 patients at 72 h. Median values were 95.0, 50.9, 86.0, and 20.3 mg/l, respectively. the area under the ROC curve was 0.99 for PCT and 0.54 for CRP. Cut off concentrations to differentiate SIRS from sepsis were >2 ng/ ml for PCT and >79 mg/l for CRP.Conclusion: PCT is able to differentiate between SIRS and sepsis while CRP is not. Moreover, unlike CRP, PCT concentrations varied with the evolution of sepsis.
Language English
Date 2006-02-01
Published in Archives of Disease in Childhood. London: B M J Publishing Group, v. 91, n. 2, p. 117-120, 2006.
ISSN 0003-9888 (Sherpa/Romeo, impact factor)
Publisher B M J Publishing Group
Extent 117-120
Access rights Closed access
Type Article
Web of Science ID WOS:000234760100010

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