Discrimination of infectious and noninfectious causes of early acute respiratory distress syndrome by procalcitonin

Brunkhorst, Frank M.; Eberhard, Oliver K.; Brunkhorst, Reinhard

doi:10.1097/00003246-199910000-00016

Cited by 165 publications

(96 citation statements)

References 14 publications

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“…Serum values of procalcitonin vary greatly based on the type and severity of infection [4,5]. Few studies have analysed the behaviour of procalcitonin in lung infection [6][7][8][9]. However, the use of procalcitonin levels for the diagnosis of VAP has not been established.…”

Section: Discussionmentioning

confidence: 99%

“…The levels of procalcitonin have been successfully applied in different diseases in order to determine the presence of an active infectious process [5]. Nonetheless, few studies have analysed the behaviour of procalcitonin levels when the infection is in the lung [6][7][8][9]. Furthermore, there are even fewer studies aiming to establish a diagnostic cut-off value of procalcitonin levels in VAP and their results are discordant [10][11][12].…”

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confidence: 99%

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Sequential measurements of procalcitonin levels in diagnosing ventilator-associated pneumonia

Ramírez

Garcia²,

Ferrer³

et al. 2007

Eur Respir J

114

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The utility of procalcitonin levels to improve the accuracy of clinical and microbiological parameters in diagnosing ventilator-associated pneumonia (VAP) was evaluated.Sequential measurement of procalcitonin and C-reactive protein levels and the calculation of the simplified Clinical Pulmonary Infection Scores (CPIS) were performed in 44 patients mechanically-ventilated for .48 h with neither active infection for the duration or suspicion of VAP. Patients who developed extrapulmonary infection were excluded.In total, 20 cases were suspected of having VAP and diagnosis was microbiologically confirmed in nine. In patients with confirmed VAP, procalcitonin levels were higher than in those without VAP. C-reactive protein levels and CPIS were lower in patients without suspected VAP, but could not discriminate confirmed and nonconfirmed suspicion of VAP. The best sensitivity and specificity (78 and 97%, respectively) corresponded to procalcitonin. The CPIS resulted in the same sensitivity, but had a lower specificity (80%). C-reactive protein had the worst sensitivity (56%), but a good specificity (91%). A CPIS o6 combined with serum levels of procalcitonin o2.99 ng?mL -1 did not improve the sensitivity (67%), but resulted in 100% specificity.Procalcitonin might be useful in the diagnosis of ventilator-associated pneumonia. Combined values of Clinical Pulmonary Infection Scores and procalcitonin below the cut-off points excluded false-positive diagnoses of ventilator-associated pneumonia.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Sequential measurements of procalcitonin levels in diagnosing ventilator-associated pneumonia

Ramírez

Garcia²,

Ferrer³

et al. 2007

Eur Respir J

114

View full text Add to dashboard Cite

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“…C-Reactive protein (CRP), an inflammatory marker usually appears in blood, 12 hours after the onset of inflammation and may rise in both infectious and noninfectious pathologies, thus making it less sensitive and nonspecific to diagnose bacterial pneumonia in children. 21 Most of the times blood cultures in patients of bacterial pneumonia are negative, and only a small amount of blood sample are withdrawn from children, therefore we must use other diagnostic procedures to diagnose the disease in question.…”

Section: Discussionmentioning

confidence: 99%

Role of serum procalcitonin level in early diagnosis of bacterial pneumonia in children, a hospital based study

2016

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“…PCT was found to be an accurate diagnostic parameter for differentiating SIRS and sepsis [5]. Previously, PCT was reported to be a better discriminator than CRP in characterizing the degree of inflammation related to infection [17], especially infection complicated by sepsis or organ failure [18]. With this background, PCT has been proposed as a better prognostic marker than CRP [19,20].…”

Section: Discussionmentioning

confidence: 99%

Value of Serum Procalcitonin in Evaluating the Prognosis of Sepsis in Elderly Patients with Colorectal Cancer Undergoing Emergency Colorectal Surgery

Zou

Cai

et al. 2012

Indian J Surg

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Serum procalcitonin (PCT) levels may have predictive value in the prognosis of postoperative sepsis in elderly patients who have undergone colorectal surgery for colorectal cancer in intensive care units (ICUs). A prospective study involving 90 critically ill patients who underwent colorectal surgery for colorectal cancer in ICUs was performed. Twenty-eight patients were diagnosed with sepsis, in accordance with the American College of Chest Physicians/Society of Critical Care Medicine consensus criteria, and these patients were included in the sepsis group. Sixtytwo patients, who were without evidence of sepsis, were enrolled in the control group. We measured the serum PCT concentrations preoperatively (immediately before induction of anesthesia), upon arrival in the ICU (ICU day 0), on the morning of the first postoperative day (postoperative day 1), and on the morning of the third postoperative day (postoperative day 3). The C-reactive protein (CRP) index, acute physiology and chronic health evaluation II (APACHE II) score, mechanical duration of ventilation, mortality rate, incidence of multiple organ failure, and usage of continuous renal replacement therapy were evaluated. The area under the curve for the receiver operating characteristic curve (AUC-ROCC) was measured to explore the association between the serum PCT and the prognosis. In the sepsis group, 12/28 patients died (mortality rate 43 %). In the control group, 6/ 62 patients died (mortality rate 9.7 %). On the first postoperative day, the serum PCT level was dramatically higher in the sepsis group than in the control group (2.71±1.13 vs. 1.37± 0.57, P≤0.05). The PCT level on the first postoperative day was distinctly higher than that measured upon arrival in the ICU (2.71±1.13 vs. 1.31±0.58, P≤0.05). In the two groups, the CRP concentrations were both markedly higher on the first postoperative day than upon arrival in the ICU (138.89±45.12 vs. 70.43±23.54 in the sepsis group, and 133.13±44.91 vs. 69.65±24.98 in the control group, P≤0.05). Linear regression analysis was performed. The results suggest that the PCT and APACHE-II scores were not significantly associated. On the first and third postoperative days, the PCT levels were associated with increased odds of sepsis (AUC-ROCC, 95 % confidence interval 0.817-0.973, P 00.000, and 0.755-0.944, P00.000, respectively). The outcomes of patients in the sepsis group were worse than those in the control group. PCT levels appear to be early markers of postoperative sepsis in elderly patients undergoing colorectal surgery for colorectal cancer during the ICU course. These findings could allow for early identification of postoperative septic complications and be used for prognostic evaluation of these patients.

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Discrimination of infectious and noninfectious causes of early acute respiratory distress syndrome by procalcitonin

Abstract: PCT determination in early ARDS could help to discriminate between septic and nonseptic underlying disease.

Cited by 165 publications

References 14 publications

Sequential measurements of procalcitonin levels in diagnosing ventilator-associated pneumonia

Sequential measurements of procalcitonin levels in diagnosing ventilator-associated pneumonia

Role of serum procalcitonin level in early diagnosis of bacterial pneumonia in children, a hospital based study

Value of Serum Procalcitonin in Evaluating the Prognosis of Sepsis in Elderly Patients with Colorectal Cancer Undergoing Emergency Colorectal Surgery

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