Procalcitonin &amp;ndash; ein prognostischer Infektions- parameter bei der Peritonitis

Keith, Helen; Lehmkuhl, Peter; W, Beier; Högy, B.

doi:10.1159/000189906

Cited by 14 publications

(15 citation statements)

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“…In a clinical study, Ober-hoffer et al report high PCT levels in patients with poor prognosis already during the onset of the disease [4]. Further studies support the notion that the course of PCT concentrations rather than the absolute height is a mirror of the systemic inflammatory response and plays a major role for prognosis [4,10,18,19]. Also with regard to this aspect, PCT is superior to CRP, since patients with a lethal outcome were not distinguished by CRP at any time in our study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS

et al. 1999

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Objectives:The relation of procalcitonin (PCT) plasma concentrations compared with C-reactive protein (CRP) was analyzed in patients with different severity of multiple organ dysfunction syndrome (MODS) and systemic inflammation.Patients and methods: PCT, CRP, the sepsis-related organ failure assessment (SOFA) score, the Acute Physiology, Age, Chronic Health Evaluation (APACHE) II score and survival were evaluated in 40 patients with systemic inflammation and consecutive MODS over a period of 15 days.Results: Higher SOFA score levels were associated with significantly higher PCT plasma concentrations (SOFA 7-12: PCT 2.62 ng/ml, SOFA 19-24: PCT 15.22 ng/ml) (median), whereas CRP was elevated irrespective of the scores observed (SOFT 7-12: CRP 131 mg/l, SOFT 19-24: CRP 135 mg/l). PCT of non-surviving patients was initially not different from that of survivors but significantly increased after the fourth day following onset of the disease, whereas CRP was not different between both groups throughout the whole observation period. Conclusions:Measurement of PCT concentrations during multiple organ dysfunction syndrome provides more information about the severity and the course of the disease than that of CRP. Regarding the strong association of PCT and the respective score systems in future studies we recommend evaluation also of the severity of inflammation and MODS when PCT concentrations were compared between different types of disease.Address:

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Section: Discussionmentioning

confidence: 99%

Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS

et al. 1999

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“…Recently, PCT was found to be elevated in patients with severe bacterial or fungal infections and sepsis (2,3,(15)(16)(17). The diagnostic and prognostic value of elevated levels of PCT was first described by Nylen et al in 1992 (18) in severely burned patients.…”

Section: Introductionmentioning

confidence: 99%

“…During the last years, several new parameters have been introduced which have been reported to be more sensitive to bacterial infections and which allow a better classification of the patients. These are procalcitonin (PCT) (2,3), polymorphonuclear neutrophil leucocytes (PMN)-elastase, neopterin (4,5), soluble (s)CD14 (6,7), and interleukins (8,9).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Procalcitonin, sCD14 and Interleukin-6 Values in Septic Patients

Herrmann

Ecker²,

Quast³

et al. 2000

CCLM

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The aim of the study was to investigate whether procalcitonin, soluble CD14 and interleukin-6 show advantages in predicting the outcome and specificity for bacterial infection in patients with sepsis in comparison to common C-reactive protein measurement. Laboratory parameters were measured in plasma of patients during 14 days following the diagnosis of sepsis. Patients fulfilling the ACCP/SCCM criteria for sepsis were admitted to an intensive care unit (n=35). Procalcitonin was measured with an immunoluminometric assay, and soluble CD14 and interleukin-6 were analysed by ELISA. C-reactive protein was determined nephelometrically. Measurements were performed on days 0, 1, 2, 3, 4, 7 and 14. Separating the patients into survivors (n=22) and non-survivors (n=13), it was demonstrated that non-survivors mostly exhibited, after the day of admission, increasing procalcitonin concentrations which peaked around days three and four. In contrast, the procalcitonin concentrations of survivors fell continuously to the value of 2.1 ng/ml which was reported to be important for patients prognosis. The difference between procalcitonin median values of survivors (n=22) and non-survivors (n=13) attained the level of statistical significance on day 7 and on day 14 (p=0.05). When comparing the median values of Creactive protein, soluble CD14 and interleukin-6 between survivors and non-survivors, no significant differences were detectable. In this study, plasma concentrations of soluble CD14 and interleukin-6 showed no predictive value for patients' outcome as compared with established laboratory parameters such as C-reactive protein or leukocyte count. Monitoring of procalcitonin seemed to detect severe episodes of sepsis and may improve the laboratory monitoring of septic patients.

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“…Interleukin‐6 (IL‐6) and TNF‐α also correlate closely with the extent of the systemic inflammatory response and have prognostic value in defined phases of the clinical course [19,20]. Increases in serum levels of TNF‐α and IL‐6 have been shown to be early signs of neonatal sepsis [21,22].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, elevated IL‐6 levels can also be found following surgical procedures, thus rendering it impossible to differentiate an acute bacterial infection from the normal wound healing by cytokines, whereas PCT‐levels only increase in the case of bacterial infection or after major surgery [5,19].…”

Section: Introductionmentioning

confidence: 99%

Procalcitonin: a new parameter for the diagnosis of bacterial infection in the peri-operative period

Oczenski¹,

Fitzgerald²,

Schwarz³

1998

Eur J Anaesthesiol

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Procalcitonin, a new innovative inflammation parameter is presently being evaluated in clinical studies. It has been shown to be increased markedly in patients with severe bacteria induced inflammation, septic shock, endotoxinaemia and multiple organ failure. In contrast, severe viral infections or inflammatory reactions of non-infectious origin as well as auto-immune or allergic disorders do not or only very moderately increase procalcitonin serum levels. Because procalcitonin is observed at significantly higher concentrations in bacterial infections, it might assist differentiation between these infections and other aetiologies of critical illnesses. Furthermore, procalcitonin correlates with the severity of infection and sepsis and thus could serve as a useful marker for monitoring surgical high risk patients. Procalcitonin may serve as a valid and sensitive indicator for bacterial infection with important diagnostic potential in the peri-operative period and in intensive care medicine.

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Procalcitonin – ein prognostischer Infektions- parameter bei der Peritonitis

Cited by 14 publications

References 0 publications

Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS

Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS

Comparison of Procalcitonin, sCD14 and Interleukin-6 Values in Septic Patients

Procalcitonin: a new parameter for the diagnosis of bacterial infection in the peri-operative period

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