Detection of Acute Phase Response and Infection. The Role of Procalcitonin and C-Reactive Protein

Rothenburger, Markus; Markewitz, Andreas; Lenz, T.; Kaulbach, H C; Marohl, K; Kuhlmann, Wolf-Dieter; Weinhold, C

doi:10.1515/cclm.1999.048

Cited by 80 publications

(66 citation statements)

References 26 publications

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“…Until now it has been difficult to recommend universal cut-off points for PCT, which clearly differentiate a normal from a complicated postoperative course. In the literature the cut-off points range from 1 ng/ml to 5 ng/ml [16,21,22]. Sponholz et al [16] advise interpreting PCT levels according to the clinical context.…”

Section: Discussionmentioning

confidence: 99%

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

Carboni

Fahrner

Gazdhar

et al. 2008

European Journal of Cardio-Thoracic Surgery

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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. #

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Section: Discussionmentioning

confidence: 99%

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

Carboni

Fahrner

Gazdhar

et al. 2008

European Journal of Cardio-Thoracic Surgery

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“…17,18 Outcomes also vary for CRP in postoperative cohort studies. In one study, elevated CRP levels were detected in patients who developed systemic infections following surgery, 19 however, most studies revealed that CRP is not a useful predictor of sepsis in patients following surgical intervention: Plasma CRP concentrations were high in almost all infectious and noninfectious systemic processes. [20][21][22] Measurement of acute-phase derivative markers, such as PCT and CRP, is timeconsuming, costly, and not widely available.…”

Section: Introductionmentioning

confidence: 96%

Intensive Care Infection Score – A new approach to distinguish between infectious and noninfectious processes in intensive care and medicosurgical patients

et al. 2015

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Objectives: Clinicians regularly encounter substantial time delays in diagnosing sepsis and administering appropriate antibiotic treatment. This study investigated the ability of the Intensive Care Infection Score (ICIS) to distinguish between infectious and noninfectious processes, and to assess the justified commencement of antibiotic therapy retrospectively, in line with hospital actual best practice and applied laboratory parameters. Methods: Intensive-care unit (ICU) patients were enrolled in this retrospective, observational study. Clinical data and laboratory parameters were determined daily. The cohort was divided into infected and noninfected patient groups. Results: Out of 172 ICU patients, including 72 postoperative patients, the predictive value for infection throughout the first 5 days in 'all patients' and the 'postoperative patient' group was highest for ICIS. An ICIS cut-off value of three could predict infection in postoperative patients with 82.9% sensitivity and 75.1% specificity. ICIS showed the lowest rate of potentially 'falsely encouraged' and 'discouraged' antibiotic therapies for noninfected and for septic postoperative patients, respectively, compared with C-reactive protein, procalcitonin and white blood cell levels.

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“…Because the suspicion of sepsis in the neonate is often based on non-specific clinical signs, several predictive laboratory parameters have been investigated, including white blood cell count, tumor necrosis factor, interleukin-6, serum amyloid A, procalcitonin and C-reactive protein (CRP) (4)(5)(6)(7)(8). Serial CRP measurements are also used to monitor the evolution of bacterial diseases because CRP concentration drops quickly in response to effective treatment (9). Monitoring CRP concentration can lead to shorter antibiotic regimens or, alternatively, can alert one to the likelihood of complications and help predict outcome, even earlier than clinical signs (10).…”

Section: Introductionmentioning

confidence: 99%

Reliability of two different bedside assays for C-reactive protein in newborn infants

Zecca

Barone

Corsello

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: Bedside tests for C-reactive protein (CRP) have been studied in pediatric patients, but not in neonates. Methods:This study compared the results of two rapid bedside tests for CRP (Quick-Read CRP, Orion Diagnostic, Espoo, Finland and NycoCard CRP-Single Test, Axis-Shield, Oslo, Norway) with those of our central laboratory method (CRP-Lab) in newborn infants. CRP concentrations were determined using 72 samples obtained from 43 infants with suspected sepsis occurring between 1 and 28 days of life. Results: Considering positive CRP concentrations to be G10 mg/L, both bedside tests had good specificity (Quick-Read 80.5%, NycoCard 83.3%) and sensitivity (Quick-Read 97.2%, NycoCard 94.4%) when compared with our CRP-Lab. The agreement of measurement with central laboratory values was high for both the bedside tests, without statistically significant differences between the methods. The Quick-Read and NycoCard methods did not show any statistically significant systematic proportional bias when compared with the central laboratory values. The accuracy of the results of both bedside tests is somewhat decreased when CRP concentrations are )100 mg/L. Conclusions: This study shows that both the QuickRead and the NycoCard test can be used for serial determinations of CRP concentrations in newborn infants. They require small volumes of blood and provide reliable results in -5 min.

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Detection of Acute Phase Response and Infection. The Role of Procalcitonin and C-Reactive Protein

Abstract: Due to the significant differences in the degree of increase, PCT appears to be useful in discriminating between acute phase response following cardiac surgery with CPB or local problems and systemic infections, with additional CRP-measurement increasing the specificity.

Cited by 80 publications

References 26 publications

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

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

Intensive Care Infection Score – A new approach to distinguish between infectious and noninfectious processes in intensive care and medicosurgical patients

Reliability of two different bedside assays for C-reactive protein in newborn infants

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