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Intensive Care Med. 2006 Jun;32(6):881-7. Epub 2006 Apr 28.

Procalcitonin kinetics in pediatric patients with systemic inflammatory response after open heart surgery.

Author information

1
Istanbul University, Cardiology Institute, Anesthesiology and Intensive Care Department, Istanbul, Turkey. sdrcelebi@yahoo.com

Abstract

OBJECTIVE:

To evaluate procalcitonin and C-reactive protein as markers of inflammation severity and their value in predicting development of organ failure after pediatric open heart surgery.

DESIGN:

Prospective, observational, clinical study.

SETTING:

Single university hospital.

PATIENTS:

Thirty-three pediatric patients with systemic inflammatory response syndrome (SIRS; n=19) and SIRS+organ failure (SIRS+OF; n=14) following open heart surgery were included.

MEASUREMENTS AND RESULTS:

Plasma procalcitonin and C-reactive protein levels were measured before and after the operation, and 1, 2, 3, and 4 days after surgery. Patients were evaluated daily to assess organ failure. Postoperative procalcitonin levels in the SIRS+OF group were significantly higher than in the SIRS group. C-reactive protein levels were similar between the groups throughout the study period. Peak procalcitonin levels were found to be positively correlated with aortic cross-clamp and cardiopulmonary bypass times, duration of mechanical ventilation, intensive care unit and hospital stay, mortality and organ failure development. Peak procalcitonin was found to be a good predictor of postoperative organ failure development and mortality. However, the predictive value of peak C-reactive protein for organ failure and mortality was found to be weak. Double-peak procalcitonin curves were observed in SIRS+OF patients with infection during the intensive care unit stay.

CONCLUSION:

In the SIRS+OF group peak procalcitonin levels were found to be highly predictive for mortality and organ failure development, whereas C-reactive protein levels were not. Daily procalcitonin measurements in SIRS+OF patients may help identify the postoperative infection during the follow-up period.

PMID:
16715328
DOI:
10.1007/s00134-006-0180-z
[Indexed for MEDLINE]
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