Procalcitonin and Pediatric Traumatic Brain Injury: Differentiating Neuro-storming From Infection

Lotakis, Dimitra M.; Vernamonti, Jack; Ehrlich, Peter F.; Gadepalli, Samir K.

doi:10.1016/j.jss.2023.03.045

Cited by 2 publications

(2 citation statements)

References 32 publications

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“…In pediatric patients, the relationship between post-traumatic procalcitonin and sepsis and microbiological culture positivity in the PICU has been extensively investigated in the literature. [ 17 – 19 ] There are also studies showing that it can be used for sepsis detection in critically ill burn patients. [ 14 ] However, studies in adult populations have also examined the relationship between trauma severity and procalcitonin levels.…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin and blood lactate level as predictive biomarkers in pediatric multiple trauma patients’ pediatric intensive care outcomes: A retrospective observational study

Colak,

Arda Kilinc,

Güven

et al. 2023

Medicine

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Pediatric trauma represents a significant source of morbidity and mortality in children, encompassing a broad spectrum of injuries. Despite advancements in the treatment and prevention of injuries, the risk of trauma in children remains a persistent concern. Severe trauma cases often necessitate admission to a pediatric intensive care unit (PICU). Procalcitonin, an essential biomarker that elevates bacterial infections and trauma, and elevated lactate levels can signal adverse outcomes in critically ill patients. This study retrospectively examined pediatric patients with multiple trauma treated at the Başakşehir Çam and Sakura City Hospital PICU between 2021 and 2023. The analysis sought to evaluate the relationship between initial procalcitonin and lactate levels with the duration of stay in the PICU, the length of invasive mechanical ventilation (IMV), and the duration of inotropic support. Furthermore, a comparison was made between procalcitonin and lactate levels in survivors and non-survivors, analyzing their potential influence on PICU outcomes and mortality. For pediatric multi-trauma patients, the median duration of stay in the PICU was found to be 3 days. Among these patients, 32% necessitated IMV support and utilized it for a median of 5 days. Additionally, 36% of these patients were provided inotropic drug support for a median time of 6 days. The observed mortality rate was 11%. Procalcitonin and blood lactate levels were found to have significant predictive power for mortality with odds ratios of 1.05 (P = .04) and 1.87 (P = .02), respectively. Both blood lactate and procalcitonin levels were significantly associated with the duration of IMV support, the period of inotropic drug administration, and the length of PICU stay (P < .01; P < .01; P < .01, respectively). this research underscores the prognostic value of initial procalcitonin and lactate levels about the intensive care trajectory of pediatric trauma patients. The findings suggest that both procalcitonin and lactate levels may play pivotal roles as potential biomarkers in predicting and managing clinical outcomes in this population.

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Section: Discussionmentioning

confidence: 99%

Procalcitonin and blood lactate level as predictive biomarkers in pediatric multiple trauma patients’ pediatric intensive care outcomes: A retrospective observational study

Colak,

Arda Kilinc,

Güven

et al. 2023

Medicine

View full text Add to dashboard Cite

show abstract

“…An additional challenge lies in the fact that peripherally derived procalcitonin may enter the CSF following disruption of the blood-brain barrier. Elevated systemic procalcitonin has been documented in a variety of acute nervous system disease, such as traumatic brain injury (16), stroke (17), subarachnoid hemorrhage (18), intracerebral hemorrhage (19), and status epilepticus (20); these challenge the potential specificity of this marker for infectious insults as etiology. However, the omission of correlative data on CSF procalcitonin and the lack of assessment of infection as the primary outcome hinder the relevance of these reports for clinical practice.…”

mentioning

confidence: 99%

Procalcitonin As Diagnostic Tool for CNS Infections—Overall, Not Good Enough (Yet?)*

Pizzi,

Busl

2023

Critical Care Medicine

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Procalcitonin and Pediatric Traumatic Brain Injury: Differentiating Neuro-storming From Infection

Cited by 2 publications

References 32 publications

Procalcitonin and blood lactate level as predictive biomarkers in pediatric multiple trauma patients’ pediatric intensive care outcomes: A retrospective observational study

Procalcitonin and blood lactate level as predictive biomarkers in pediatric multiple trauma patients’ pediatric intensive care outcomes: A retrospective observational study

Procalcitonin As Diagnostic Tool for CNS Infections—Overall, Not Good Enough (Yet?)*

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