Valor pronóstico del aclaramiento de procalcitonina, PCR y leucocitos en el shock séptico

Suberviola, Borja; Castellanos-Ortega, Álvaro; González-Castro, A.; García-Astudillo, Luis A.; Fernández-Miret, Borja

doi:10.1016/j.medin.2011.09.008

Cited by 51 publications

(20 citation statements)

References 36 publications

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“…Ruiz-Rodriguez demonstrated that in 27 patients with septic shock, both PCT clearance at 24 and 48 hours were highly predictive of survival with AUC of 0.74 (95% CI, 0.54–0.950) and 0.86 (95% CI, 0.69–1.0), respectively. In another study involving 88 patients with septic shock, Suberviola et al [19] showed that PCT clearance at 72 hours was higher in survivors compared to nonsurvivors and is predictive of survival with an AUC of 0.79. These 2 studies involved a high risk profile group of patients with septic shock.…”

Section: Discussionmentioning

confidence: 99%

“…This was recently investigated by Schuetz et al [31] who showed that a cut-off point of 80% within 72 hours was associated with an abrupt increase in mortality (9.5% versus 47.8%) and had a high negative predictive value and sensitivity. In addition, Suberviola et al [19] also showed an optimal cut-off point of 70% for PCTc-72 in predicting survival. In contrast, a lower cut-off point of 30% for PCT decrease within 24 hours, [30] and 48 hours [32] had been shown to be prognostic of survival.…”

Section: Discussionmentioning

confidence: 99%

“…Dynamic approach of assessing the biomarkers may give more information on the survival of the patients. A concept of procalcitonin clearance (PCTc) has been introduced in a pilot study as a tool for monitoring the evolution of PCT levels during severe sepsis [18, 19]. PCT clearance measures the relative changes in PCT to the baseline PCT and is postulated to be a better predictor of outcome.…”

Section: Introductionmentioning

confidence: 99%

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Procalcitonin Clearance for Early Prediction of Survival in Critically Ill Patients with Severe Sepsis

Nor

Ralib

2014

Critical Care Research and Practice

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Introduction. Serum procalcitonin (PCT) diagnosed sepsis in critically ill patients; however, its prediction for survival is not well established. We evaluated the prognostic value of dynamic changes of PCT in sepsis patients. Methods. A prospective observational study was conducted in adult ICU. Patients with systemic inflammatory response syndrome (SIRS) were recruited. Daily PCT were measured for 3 days. 48 h PCT clearance (PCTc-48) was defined as percentage of baseline PCT minus 48 h PCT over baseline PCT. Results. 95 SIRS patients were enrolled (67 sepsis and 28 noninfectious SIRS). 40% patients in the sepsis group died in hospital. Day 1-PCT was associated with diagnosis of sepsis (AUC 0.65 (95% CI, 0.55 to 0.76)) but was not predictive of mortality. In sepsis patients, PCTc-48 was associated with prediction of survival (AUC 0.69 (95% CI, 0.53 to 0.84)). Patients with PCTc-48 > 30% were independently associated with survival (HR 2.90 (95% CI 1.22 to 6.90)). Conclusions. PCTc-48 is associated with prediction of survival in critically ill patients with sepsis. This could assist clinicians in risk stratification; however, the small sample size, and a single-centre study, may limit the generalisability of the finding. This would benefit from replication in future multicentre study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Procalcitonin Clearance for Early Prediction of Survival in Critically Ill Patients with Severe Sepsis

Nor

Ralib

2014

Critical Care Research and Practice

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“…In the normal state of the organism it is synthesized by C-cells of the thyroid gland and, less significantly, by neuroendocrine cell lung and small intestine (9). Serum concentrations in healthy individuals are extremely low, <0.05 ng / ml, or even immeasurable (11). In systemic inflammation, particularly in bacterial infections, under the influence of inflammatory cytokines and bacterial endotoxin, it is produced in a number of tissues (lung, liver, kidney, adipose tissue) and goes in circulation, when its level can increase up to 1000 times (9,12).…”

Section: Introductionmentioning

confidence: 99%

The Importance of Serum Procalcitonin in Diagnosis and Treatment of Serious Bacterial Infections and Sepsis

Mehanic

Baljić

2013

Mater Sociomed

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The clinical utility of serum procalcitonin (PCT) levels continues to evolve. PCT is regarded as a promising candidate marker for making a diagnosis and antibiotic stewardship in patients with systemic infections. The aim of this review is to summarize the current evidence for PCT in different infections and clinical settings, and to discuss the reliability of this marker when used with validated diagnostic algorithms.

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“…Several papers have been published emphasizing the importance of measuring PCT kinetics. In patients with septic shock, Suberviola and colleagues [14] showed that a decrease in PCT levels at 72 hours was an independent marker of hospital survival. Karlsson and colleagues [11] showed that mortality in patients with severe sepsis was lower in those in whom PCT concentrations at 72 hours fell by more than 50% with respect to initial values.…”

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confidence: 99%

Predicting treatment failure in severe sepsis and septic shock: looking for the Holy Grail

Ruiz‐Rodríguez

Rello

2013

Critical Care

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Procalcitonin has been proposed as a specific biomarker of bacterial infections and has been related to the severity of sepsis. The prognostic ability of the initial concentrations of procalcitonin in sepsis is controversial. Some studies find higher initial concentrations in non-survivors but others find no differences. Prognostic assessment based on follow-up of procalcitonin levels may be better than evaluation of the initial levels of procalcitonin. The persistence of elevated procalcitonin levels is indicative of poor prognosis and is associated with mortality. Procalcitonin kinetics could be a tool for assessing the evolution of severe sepsis and sepsis shock. Procalcitonin should find its place as a biomarker for predicting treatment failure of severe sepsis and septic shock.

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Valor pronóstico del aclaramiento de procalcitonina, PCR y leucocitos en el shock séptico

Cited by 51 publications

References 36 publications

Procalcitonin Clearance for Early Prediction of Survival in Critically Ill Patients with Severe Sepsis

Procalcitonin Clearance for Early Prediction of Survival in Critically Ill Patients with Severe Sepsis

The Importance of Serum Procalcitonin in Diagnosis and Treatment of Serious Bacterial Infections and Sepsis

Predicting treatment failure in severe sepsis and septic shock: looking for the Holy Grail

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