Procalcitonina em crianças com sepse e choque séptico

Fioretto, José Roberto; Borin, Fernanda de C.; Bonatto, Rossano César; Ricchetti, Sandra M. Q.; Kurokawa, Cilmery Suemi; Moraes, Marcela Aparecida de; Carpi, Mário Ferreira; Padovani, Carlos Roberto; Martin, Joelma Gonçalves

doi:10.1590/s0021-75572007000500007

Cited by 12 publications

(3 citation statements)

References 14 publications

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“…The method shows good sensitivity and specificity in diagnosing bacterial sepsis at PCT levels of ≥2 ng/ml. [13–15] Using PCT levels above 2 ng/ml as the cut-off to indicate sepsis syndrome, the present study showed sensitivity of 86% and specificity of 95%. Using a cut-off of above 0.5 ng/ml revealed higher sensitivity but with a reduction in the specificity to 84%.…”

Section: Discussionmentioning

confidence: 56%

“…[4] Reduction in concentration of PCT has been described in response to antibiotic administration and may be used to detect antibiotic responsiveness. [91518] In the present study, serial serum PCT levels were not estimated for most patients. However, one of the patients (post-renal transplant status) from this cohort for whom 3 serum PCT levels were performed showed a marked decrease in the PCT levels in response to the antibiotics administered.…”

Section: Discussionmentioning

confidence: 77%

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Procalcitonin as an adjunctive biomarker in sepsis

et al. 2011

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Sepsis can sometimes be difficult to substantiate, and its distinction from non-infectious conditions in critically ill patients is often a challenge. Serum procalcitonin (PCT) assay is one of the biomarkers of sepsis. The present study was aimed to assess the usefulness of PCT assay in critically ill patients with suspected sepsis. The study included 40 patients from the intensive care unit with suspected sepsis. Sepsis was confirmed clinically and/or by positive blood culture. Serum PCT was assayed semi-quantitatively by rapid immunochromatographic technique (within 2 hours of sample receipt). Among 40 critically ill patients, 21 had clinically confirmed sepsis. There were 12 patients with serum PCT ≥10 ng/ml (8, blood culture positive; 1, rickettsia; 2, post-antibiotic blood culture sterile; and 1, non-sepsis); 7 patients with PCT 2-10 ng/ml (4, blood culture positive; 1, falciparum malaria; 2, post-antibiotic blood culture sterile); 3 patients with PCT of 0.5 to 2 ng/ml (sepsis in 1 patient); and 18 patients with PCT < 0.5 ng/ml (sepsis in 2 patients). Patients with PCT ≥ 2 ng/ml had statistically significant correlation with the presence of sepsis (P<0.0001). The PCT assay revealed moderate sensitivity (86%) and high specificity (95%) at a cut-off ≥ 2 ng/ml. The PCT assay was found to be a useful biomarker of sepsis in this study. The assay could be performed and reported rapidly and provided valuable information before availability of culture results. This might assist in avoiding unwarranted antibiotic usage.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 77%

Procalcitonin as an adjunctive biomarker in sepsis

et al. 2011

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“…(31) In another prospective observational study in a pediatric intensive care unit in São Paulo, Brazil, involving 689 patients admitted within 2 years and including 59 children with criteria for sepsis and 65 children with criteria for septic shock, the plasma levels of PCT at admission allowed differentiation between sepsis and septic shock. (33) These results suggest the validity of using PCT in auxiliary diagnosis of septic conditions in children and its potential usefulness as an indicator of disease severity; the latter may be useful for evaluating the appropriateness of patient hospitalization in the pediatric intensive care unit, for example.…”

Section: Introductionmentioning

confidence: 83%

Use of biomarkers in pediatric sepsis: literature review

Lanziotti

Póvoa

Soares

et al. 2016

Revista Brasileira De Terapia Intensiva

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Despite advances in recent years, sepsis is still a leading cause of hospitalization and mortality in infants and children. The presence of biomarkers during the response to an infectious insult makes it possible to use such biomarkers in screening, diagnosis, prognosis (risk stratification), monitoring of therapeutic response, and rational use of antibiotics (for example, the determination of adequate treatment length). Studies of biomarkers in sepsis in children are still relatively scarce. This review addresses the use of biomarkers in sepsis in pediatric patients with emphasis on C-reactive protein, procalcitonin, interleukins 6, 8, and 18, human neutrophil gelatinase, and proadrenomedullin. Assessment of these biomarkers may be useful in the management of pediatric sepsis.

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A new procalcitonin cord-based algorithm in early-onset neonatal infection: for a change of paradigm

Lencot

Cabaret

Sauvage³

et al. 2014

Eur J Clin Microbiol Infect Dis

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Diagnostic of early-onset neonatal infection (EONI) remains an emergency. Recent studies underline the potential benefit of using Procalcitonin (PCT) in early diagnosis of bacterial infections in neonates. The aim of this study was to evaluate the diagnostic value of an umbilical blood cord PCT based algorithm in newborns suspected of EONI. The diagnostic value of the PCT based algorithm was compared to the French one currently in use by analyzing an 18-months database of newborns suspected of EONI in University Hospital of Nantes from March 2011 to September 2012. Among the 2,408 (40.8 %) newborns suspected of infection during this period, 2,366 were included in the study. The incidence of EONI was 3.4‰ (n = 20). There was no significant difference between the sensibilities of the PCT based algorithm and the current algorithm (90 %, respectively, 95%CI 76.9-100 versus 85.4-100; p = 0.90) and between their specificities (respectively 91.7 % (90.6-92.8) versus 87.4 % (86-88.7); p = 0.25). The antibiotic treatment rate would be significantly reduced with the PCT based algorithm [211 i.e. 8.9 % (7.8-10) versus 314 i.e. 13.3 % (11.9-14.7) in the current algorithm; p < 0.005] and less biological analysis would be performed [301 i.e. 12.7 % (11.4-14) versus 937 i.e. 39.6 % (37.6-41.6); p < 0.005]. Blood cord PCT seems to be a new and efficient marker to guide neonatologists taking care of newborns suspected of EONI. The PCT algorithm seems to be a safe alternative in diagnosis of EONI, allowing detection of EONI significantly as well as the current algorithm, without resulting in a substantially higher number of missed infections. These results have to be confirmed by a multicentric validation study.

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Procalcitonina em crianças com sepse e choque séptico

Cited by 12 publications

References 14 publications

Procalcitonin as an adjunctive biomarker in sepsis

Procalcitonin as an adjunctive biomarker in sepsis

Use of biomarkers in pediatric sepsis: literature review

A new procalcitonin cord-based algorithm in early-onset neonatal infection: for a change of paradigm

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