Predictive value of procalcitonin for intestinal ischemia and/or necrosis in pediatric patients with adhesive small bowel obstruction (ASBO)

Role of Procalcitonin in the Timely Detection of Ischemia and Necrosis in Children With Intestinal Obstruction

“…As of this moment, there is not a gold standard for the early identi cation of I/N, however, elevated PCT has shown a clear association with this complication. [13][14][15][16][17][18][19].…”

“…The increase in PCT has shown signi cant value in the identi cation of I/N, mainly in patients with ASBO, reporting sensitivities of 72-100%, speci cities of 73-91%, PPV of 40-89% and NPV of 80-92%, although the reported PCT positive threshold ranges from 0.25 ng/ml to 2 ng/ml [13][14][15][16][17][18][19]. In the present study, we only included patients who required surgical management, which gives more accuracy because we could observe macroscopically and microscopically (in patients who undergone bowel resection) the real status of the bowel, differing with our previous study where patients who responded successfully to medical treatment were quali ed as with absence of I/N [19] which can be a source of bias. The prevalence of I/N was 36%, which is like those reported in other series [13,24], which makes our diagnostic and predictive values reliable.…”

“…Two ml of blood were taken in a heparin-free tube for each sample, which was centrifugated and the serum was used to measure PCT levels by a quantitative CLIA assay (LIAISON® BRAHMS PCT® II GEN). Taking our previous report as a reference (19), the normal reference value for PCT was considered < 1.0 ng/ml and PCT level ≥ 1.0 ng/ml was considered elevated.…”

“…Subsequently, multiples studies investigated the role of PCT in the management and prognosis of adult patients with adhesive small bowel obstruction (ASBO) showing encouraging results (13)(14)(15)(16)(17)(18). In 2017, we published the rst study in pediatric patients that demonstrated correlation between the increase in PCT and presence of I/N in patients with ASBO (19) and suggested that a PCT greater than 1.0 ng/ml should be indicative of surgical management due to this association. Nonetheless, this study was exclusive for patients with ASBO including those managed with medical treatment and surgery; we got some false negatives, which we believe were from taking PCT every 24 hours or maybe because we granted that ABSO that didn't require surgery had no I/N.…”

The dynamics of levels of lypopolysaccharide-binding protein and procalcitonin during the experimental acute intestinal o bstruction

“…Современным направлением для более точной диагностики вышеизложенных проблем является определение биомаркеров бактериальной миграции, играющих роль как в детекции данного явления, так и в качестве предикторов септических инцидентов в клинике острой кишечной непроходимости [4]. Наиболее известными биомаркерами бактериальной транслокации на сегодняшний день являются уровни прокальцитонина и липополисахаридсвязывающего белка в сыворотке крови [5,6,7].…”