Plasma Concentrations and Clearance of Procalcitonin During Continuous Veno-Venous Hemofiltration in Septic Patients

Meisner, Michael; Hüttemann, E.; Lohs, Torsten; Kasakov, Leonid; Reinhart, Konrad

doi:10.1097/00024382-200115030-00002

Cited by 35 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the lack of significant change in our investigated inflammatory biomarker levels in patients with chronic renal failure also agrees with earlier results [30–33]. Those data showed that urinary PCT levels were significantly reduced in patients with severe renal dysfunction.…”

Section: Discussionsupporting

confidence: 93%

Pre-analytic factors and initial biomarker levels in community-acquired pneumonia patients

Kutz¹,

Grolimund²,

Thomann

et al. 2014

BMC Anesthesiol

View full text Add to dashboard Cite

BackgroundBlood biomarkers are increasingly used to diagnose, guide therapy in, and risk-stratify community-acquired pneumonia (CAP) patients in emergency departments (EDs). How pre-analytic factors affect these markers’ initial levels in this population is unknown.MethodsIn this secondary analysis of consecutive ED patients with CAP from a large multicentre antibiotic stewardship trial, we used adjusted multivariate regression models to determine the magnitude and statistical significance of differences in mean baseline concentrations of five biomarkers (procalcitonin [PCT], C-reactive protein [CRP], white blood cells count [WBC], proadrenomedullin [ProADM], copeptin) associated with six pre-analytic factors (antibiotic or corticosteroid pretreatment, age, gender, chronic renal failure or chronic liver insufficiency).ResultsOf 925 CAP patients (median age 73 years, 58.8% male), 25.5% had antibiotic pretreatment, 2.4%, corticosteroid pretreatment, 22.3%, chronic renal failure, 2.4% chronic liver insufficiency. Differences associated with pre-analytic factors averaged 6.1% ±4.6%; the three largest statistically significant changes (95% confidence interval) were: PCT, +14.2% (+2.1% to +26.4%, p = 0.02) with liver insufficiency; ProADM, +13.2% (+10.2% to +16.1%, p < 0.01) with age above median; CRP, -12.8% (-25.4% to -0.2%, p = 0.05) with steroid pretreatment. In post hoc sensitivity analyses, reclassification statistics showed that these factors did not result in significant changes of biomarker levels across clinically used cut-off ranges.ConclusionsDespite statistically significant associations of some pre-analytic factors and biomarker levels, a clinically relevant influence seems unlikely. Our observations reinforce the concept of using biomarkers in algorithms with widely-separated cut-offs and overruling criteria considering the entire clinical picture.Trial registrationIdentifier ISRCTN95122877.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2253-14-102) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 93%

Pre-analytic factors and initial biomarker levels in community-acquired pneumonia patients

Kutz¹,

Grolimund²,

Thomann

et al. 2014

BMC Anesthesiol

View full text Add to dashboard Cite

show abstract

“…However, CPB itself does not induce significant amounts of PCT, when compared with thoracic surgery without ECC, unless extensive times of ECC are used [6]. In addition, other types of EEC, for example continuous veno-venous haemodialysis or haemofiltration, do not induce PCT [37,38]. Given the physiological time course of PCT induction, its synthesis obviously starts shortly after surgery.…”

Section: Discussionmentioning

confidence: 99%

Early increase of procalcitonin after cardiovascular surgery in patients with postoperative complications

et al. 2002

View full text Add to dashboard Cite

Elevated PCT, but not CRP, correlates with evidence of systemic inflammation and other complications early postoperatively after cardiac surgery. Although the PCT levels do not rise as quickly as the criteria of the systemic inflammatory response syndrome appear, they do reflect systemic inflammation. Early identification and quantification of a systemic inflammatory response may help reduce postoperative complications.

show abstract

“…On the contrary, levels fall rapidly when infection gets controlled and correlate with down regulation of its gene in several tissues (46). Continuous veno-venous hemofiltration does not significantly influence PCT plasma concentrations or kinetics in patients with sepsis and PCT can be used for diagnostic purposes in this patient population (47). Circulating levels of PCT demonstrate a superior diagnostic accuracy when compared to other established biomarkers and indicators of sepsis (48, 49), and are unaffected by the administration of anti-inflammatory therapy, such as glucocorticoids, when compared to CRP (50).…”

Section: Potential Marker Of Infection: Procalcitoninmentioning

confidence: 99%

Role of Biomarkers in Sepsis Care

Samraj

Zingarelli

Wong

2013

Shock

129

100

View full text Add to dashboard Cite

Sepsis is one of the leading causes of mortality and morbidity, even with the current availability of extended spectrum antibiotics and advanced medical care. Biomarkers offer a tool in facilitating early diagnosis, in identifying patient populations at high risk of complications, and in monitoring progression of the disease, which are critical assessments for appropriate therapy and improvement in patient outcomes. Several biomarkers are already available for clinical use in sepsis; however, their effectiveness in many instances is limited by the lack of specificity and sensitivity to characterize the presence of an infection and the complexity of the inflammatory and immune processes, and to stratify patients into homogenous groups for specific treatments. Current advances in molecular techniques have provided new tools facilitating the discovery of novel biomarkers, which can vary from metabolites and chemical products present in body fluids to genes and proteins in circulating blood cells. The purpose of this review is to examine the current status of sepsis biomarkers, with special emphasis on emerging markers, which are undergoing validation and may transition into clinical practice for their informative value in diagnosis, prognosis or response to therapy. We will also discuss the new concept of combination biomarkers and biomarker risk models, their existing challenges, and their potential use in the daily management of the sepsis patients.

show abstract

Plasma Concentrations and Clearance of Procalcitonin During Continuous Veno-Venous Hemofiltration in Septic Patients

Cited by 35 publications

References 0 publications

Pre-analytic factors and initial biomarker levels in community-acquired pneumonia patients

Pre-analytic factors and initial biomarker levels in community-acquired pneumonia patients

Early increase of procalcitonin after cardiovascular surgery in patients with postoperative complications

Role of Biomarkers in Sepsis Care

Contact Info

Product

Resources

About