Comparison of diagnostic and prognostic value of serum procalcitonin and serum lactate in pediatric sepsis

Abstract

Background:The clinical manifestations of sepsis are highly variable. The signs of both infection and organ dysfunction may be subtle, and thus the most recent international consensus guidelines provide a long list of warning signs of incipient sepsis. Lactic acid, which is a by-product of anaerobic metabolism, can be used as a marker of tissue hypoperfusion. It is being used widely. Procalcitonin has more recently been studied in children. Methods: Totally 60 Children admitted with Septic Shock in PICU between Ages 3 Months to 12 Years were assessed for Serum Lactate & Serum Procalcitonin levels. Evaluation of the biomarkers was done on individual and combinational basis using receiver operating characteristics curve. Results: Out of 60 children, male were 40, female were 20 children. In stage-1 serum lactate level was 47.83 (mg/dl) sensitivity is about 35.63 and specificity was 63.82 off p-value <0.065**.In stage -2 serum procalcitonin was 49.62 (mg/dl) sensitivity is about 37.77 and specificity was 69.28 off p-value <0.549**.In stage -3 serum procalcitonin was 52.89 (mg/dl) sensitivity is about 41.63 and specificity was 73.89 off p-value <0.651** Conclusions: Early recognition of risk factors will help in timely appropriate therapy and thereby will help in reducing mortality and morbidity in pediatric septic shock. The results suggest that PCT is valid for auxiliary diagnosis of septic conditions in children and used as an indicator of the severity of patients.