Procalcitonin as an early indicator of outcome in sepsis: a prospective observational study

Giamarellos‐Bourboulis, Evangelos J.; Tsangaris, Iraklis; Kanni, Th.; Mouktaroudi, Maria; Pantelidou, Iliana-Maria; Adamis, George; Atmatzidis, Stefanos; Chrisofos, Michael; Evangelopoulou, Vaso; Frantzeskaki, Frantzeska

doi:10.1016/j.jhin.2010.07.026

Cited by 47 publications

(33 citation statements)

References 17 publications

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“…[21] The PCT concentration change increased appropriate with the sepsis severity which was also reported by Bourboulis et al doing research in Greece with 1156 patients that there was PCT concentration change of 1.25 ng/ml to 12.37 ng/ml in the sepsis becoming septic shock and 1.78 ng/ml to 28.56 ng/ml in septic shock becoming the organ failure. [5] According to the research results conducted by Meisner that procalcitonin can be increased 2-3 hours after induction and can be increased up to several hundred of ng/ml with very stable molecule condition in vitro or in vivo. The PCT induction results in the in vivo experiment showed that in animal sepsis within 24 hours, PCT increased relatively high and IL-1β, TNF-α increased twice.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have been conducted to try to assess the role of PCT as a marker sepsis. [5][6][7] Meisner revealed that PCT concentrations increase at every degree of sepsis with a concentration of 0.05 to 0.5 ng / ml in non-septic infections, 0.5-2 ng/ml in sepsis, 2-10 ng/ml in severe sepsis, and more than 10 ng/ml in shock sepsis. [8] The Measuring PCT level can be used as an examination with the role in the diagnosis of acute bacterial infection.…”

Section: Introductionmentioning

confidence: 99%

“…However, there are also studies that found a failure to determine the PCT threshold level in the sepsis determination. [5,10] Procalcitonin is a precursor peptide of calcitonin hormone (CT), which will increase in response to an inflammatory stimulus. PCT has been suggested as bacterial infection and sepsis marker which the levels are related to the disease severity.…”

Section: Introductionmentioning

confidence: 99%

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Procalcitonin as a Biomarker of Severity Degree in Sepsis Due to Pneumonia

Prima¹

2016

AJIM

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Abstract:Measuring PCT level can be as the examination having the role to differ the systemic inflammatory response syndrome (SIRS) and sepsis. This study aims to know the PCT level in accessing the sepsis degree at pneumonia patients. This study was an analytical study with cross-sectional design. There were 30 samples obtained since February 2013 until March 2014 at the Emergency Room and Inpatient Room of Internal Medicine Local Public Hospital Dr. Zainoel Abidin Banda Aceh. The sample collection was conducted with quota sampling technique. The data was analysed with Anova and followed with LDS. The data was considered to be significant if the p value is < 0,05. The study results were obtained the minimum limit value of PCT level at pneumonia of 0,091 ng/dl, sepsis of 0,686 ng/dl, severe sepsis of 3,593 ng/dl and shock sepsis of 21,703 ng/dl. The analysis results showed that the higher PCT level makes the higher disease severity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Procalcitonin as a Biomarker of Severity Degree in Sepsis Due to Pneumonia

Prima¹

2016

AJIM

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“…This information led researchers to hypothesize that PCT might be a promising indicator for guidance of antibiotic therapy and judgment of antibiotic therapeutic efficiency in patients with infections. A variety of studies have shown that PCT levels are effective for diagnosis, outcome prediction, and efficacy of therapy for various populations, including infants, adults, and elderly patients with different sites of infections (4,11,18,30). However, a recent report assessed the value of PCT and CRP and found that in COPD patients PCT levels are not associated with bacterial presence and that benefit from antibiotic therapy is more likely with low PCT levels (9).…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis and Systematic Review of Procalcitonin-Guided Therapy in Respiratory Tract Infections

Luo

Blackwell

et al. 2011

Antimicrob Agents Chemother

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Circulating procalcitonin (PCT) is a biomarker that can be used in diagnosing bacterial infections. We performed a quantitative meta-analysis of available randomized controlled trials to determine whether antibiotic therapy based on PCT measurements alters clinical outcomes and antibiotic use in patients with lower respiratory tract infections. We identified studies through MEDLINE (1996 to 2010), the ISI Web of Knowledge (1996 to 2010), and Ovid. Studies that met our criteria were prospective, randomized controlled trials involving patients with respiratory tract infections. Outcomes of mortality, intensive care unit (ICU) admission, length of hospital stay, number of antibiotic prescriptions, and duration of antibiotic treatment were evaluated. Eight studies randomizing 3,431 patients met our criteria for inclusion. Pooled analysis showed a significant reduction in number of antibiotic prescriptions and duration of antibiotic use in patients with PCT-guided antibiotic treatment compared to standard therapy. In addition, the use of PCT-guided antibiotic therapy did not impact mortality, ICU admission, or length of hospital stay in these studies. A high degree of heterogeneity was identified in 3 of 5 outcomes that were evaluated, and sensitivity analysis indicated that heterogeneity was decreased among studies using the same PCT-based treatment algorithm. In conclusion, PCT-guided antibiotic therapy in patients with respiratory tract infections appears to reduce antibiotic use without affecting overall mortality or length of stay in the hospital.

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“…Clinically, the procalcitonin test is now widely used as a related biomarker indicative of infection, including the severity and prognosis of the infection. [15][16][17][18] The results of some studies [19][20][21] have suggested that the procalcitonin level might be relevant to the occurrence of VAP. In recent years, the Clinical Pulmonary Infection Score (CPIS) has been used both for the early diagnosis 22 of VAP and as a clinical indicator of the outcome of the infection.…”

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confidence: 99%

Diagnosing Ventilator-Associated Pneumonia in Critically Ill Patients With Sepsis

Su¹,

Meng²,

Zhang³

et al. 2012

American Journal of Critical Care

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Background Timely diagnosis and prognostic assessment of ventilator-associated pneumonia remain major challenges in critical care. Objective To explore the value of soluble triggering receptor expressed on myeloid cells 1, procalcitonin, and the Clinical Pulmonary Infection Score in the diagnosis and prognostic assessment of ventilator-associated pneumonia. Methods For 92 patients, bronchoalveolar lavage fluid was cultured for detection of microorganisms, serum levels of the receptor and procalcitonin and levels of the receptor in exhaled ventilator condensate were measured, and the Clinical Pulmonary Infection Score was calculated. Results On the day of diagnosis, patients who had pneumonia had higher serum levels of the receptor, procalcitonin, and C-reactive protein; higher white blood cell counts; and higher pulmonary infection and Sequential Organ Failure Assessment scores than did patients without pneumonia. White blood cell count (odds ratio, 1.118; 95% CI, 1.139-1.204) and serum levels of the receptor (odds ratio, 1.002; 95% CI, 1.000-1.005) may be risk factors for VAP. Serum levels of the receptor plus the pulmonary infection score were the most reliable for diagnosis; the area under the receiver operating characteristic curve was 0.972 (95% CI, 0.945-0.999), sensitivity was 0.875, and specificity was 0.95. For 28-day survival, procalcitonin level combined with pulmonary infection score was the most reliable for prognostic assessment (area under the curve, 0.848; 95% CI, 0.672-1.025). Conclusions In patients with ventilator-associated pneumonia, serum levels of the receptor plus the pulmonary infection score are useful for diagnosis, and procalcitonin levels plus the pulmonary infection score are useful for prognostic assessment.

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Procalcitonin as an early indicator of outcome in sepsis: a prospective observational study

Cited by 47 publications

References 17 publications

Procalcitonin as a Biomarker of Severity Degree in Sepsis Due to Pneumonia

Procalcitonin as a Biomarker of Severity Degree in Sepsis Due to Pneumonia

Meta-Analysis and Systematic Review of Procalcitonin-Guided Therapy in Respiratory Tract Infections

Diagnosing Ventilator-Associated Pneumonia in Critically Ill Patients With Sepsis

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