Comparison of procalcitonin and CrP in the postoperative course after lung decortication

Abstract

Objective: The objective of this prospective study was to compare the clinical value of procalcitonin (PCT) and C-reactive protein (CrP) plasma concentrations in their postoperative course after decortication. Methods: Twenty-two patients requiring surgery for pleural empyema were chosen for this prospective study. Routine blood samples including CrP and PCT plasma concentrations were taken before the operation and on the 1st, 2nd, 3rd, and 7th postoperative day. Results: Due to infection PCT and CrP were elevated preoperatively. In the postoperative course both PCT and CrP reached peak-levels on day 2 with values up to 43.55 ng/ml and 384.00 mg/l, respectively. In PCT the rise was followed by a clear decrease in 20 (90.9 %) patients until day 7. In contrast the CrP levels decreased slowly and only seven (54.5%) patients had values of 100 mg/l or below on day 7. PCT showed a better correlation with the clinic in case of septic course than CrP does. Conclusions: PCT reflects postoperative clinical course more accurately than CrP. Therefore, PCT is a more appropriate laboratory parameter to monitor patients after surgery for pleural empyema. #

Procalcitonin as preoperative marker for surgery in advanced parapneumonic empyema

“…This finding reinforces our approach of operating on patients presenting with advanced empyema as recently as they have completely recovered from pneumonia. Carboni et al analyzed postoperative PCT with CRP after decortication of 17 parapneumonic and 5 traumatic empyemas (13). Two groups were compared, one with septic signs and one without septic signs postoperatively.…”

“…Our measured CRP prior to hospital discharge (mean value 72 mg/L) reflects the usual course postoperatively (13) and did not significantly differ between the two pPCT groups.…”

“…There is current literature focusing on minimal-invasive thoracic surgery and on the identification of clinical predictors to operate successfully with thoracoscopic surgery to avoid thoracotomy and therefore major thoracic surgery (5,11,12). However, advanced parapneumonic empyema still often needs thoracotomy for complete pleural decortication (4,5,13,14). Current literature quotes a mean postoperative length of stay between 8 and 20 days in cases of thoracotomy due to empyema.…”

The rapidly expanding role of procalcitonin as a diagnostic and prognostic assay besides in UTIs

“…In fact, Nobre et al have shown that, by using this strategy, unnecessary intensive care stay is reduced by almost two days while simultaneous unnecessary exposure to antibiotics is reduced by almost three and a half days [12]. Procalcitonin levels are also valuable indicators and predictors of clinical course following surgeries such as lung decortication for empyema [13]. Similarly, procalcitonin levels can be used to assess the likelihood of wound healing after surgery.…”

Procalcitonin as an early predictor of postoperative infectious complications in patients with acute traumatic spinal cord injury

“…However, previous studies showed that peak PCT levels are reached within 24-48 h postoperatively. 30 Second, clinical evaluation of the patients was performed on the basis of a comprehensive diagnostic and/or microbiological workup and/or the assessment by an infectious diseases consultant as diagnostic standard, so not all infectious complications met the diagnostic gold standards. Third, the case number in this study was relatively small in the infected group.…”