Postoperative plasma concentrations of procalcitonin after different types of surgery

Meisner, Michael; Tschaikowsky, K.; Hutzler, Andreas; Schüttler, J.; Schick, Christoph

doi:10.1007/s001340050644

Cited by 363 publications

(246 citation statements)

References 8 publications

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“…After exposition to those toxins, serum levels of PCT increase within 2 to 4 h [20] and a peak of PCT in serum can be detected after approximately 14 h [21,22] . PCT is seen as a specific biomarker for bacterial infection [23] , although elevations of PCT in serum can also be observed under non-infectious conditions, such as trauma [24] , major surgical procedures, pancreatitis and renal impairment [25][26][27][28] . Thus, the use of PCT as a diagnostic biomarker of sepsis is discussed in a couple of meta-analyses with conflicting results [29,30] .…”

Section: Crp and Pctmentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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Beside many efforts to improve outcome, sepsis is still one of the most frequent causes of death in critically ill patients. It is the most common condition with high mortality in intensive care units. The complexity of the septic syndrome comprises immunological aspects -i.e. , sepsis induced immunosuppression -but is not restricted to this fact in modern concepts. So far, exact mechanisms and variables determining outcome and mortality stay unclear. Since there is no typical risk profile, early diagnosis and risk stratification remain difficult, which hinders rapid and effective treatment initiation. Due to the heterogeneous nature of sepsis, potential therapy options should be adapted to the individual. Biomarkers like C-reactive protein and procalcitonin are routinely used as complementary tools in clinical decision-making. Beyond the acute phase proteins, a wide bunch of promising substances and non-laboratory tools with potential diagnostic and prognostic value is under intensive investigation. So far, clinical decision just based on biomarker assessment is not yet feasible. However, biomarkers should be considered as a complementary approach. Core tip: Sepsis is a complex continuum of disturbed systems. Despite the presence of clinical consensus criteria, the early diagnosis especially in the perioperative setting is challenging. A magnitude of potential new biomarkers is tested for this purpose, but evidence is mounting that due to the complex nature of the syndrome, biomarkers are rather complementary tools for clinical decision making than "magic bullets". Moreover, biomarkers are also evaluated for therapy guidance, linking diagnostic results to an individual therapeutic regime. This review summarizes the developments in the biomarker field, aiming to provide an overview about current targets and their limitations.

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Section: Crp and Pctmentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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“…The normal level (from the third postnatal day onwards) is below 0.05 ng/mL. After surgery, the PCT level can rise to as much as 1 ng/mL (in cases of minor or aseptic surgery) or even 2 ng/mL (in cardiac surgery) [30,31] . The half-life-time of PCT is between 18 and 24 h, in patients with kidney failure, between 24 and 30 h (with a peak at 24 h) [31] .…”

Section: Introductionmentioning

confidence: 98%

“…After surgery, the PCT level can rise to as much as 1 ng/mL (in cases of minor or aseptic surgery) or even 2 ng/mL (in cardiac surgery) [30,31] . The half-life-time of PCT is between 18 and 24 h, in patients with kidney failure, between 24 and 30 h (with a peak at 24 h) [31] . As shown by Meisner et al [32] , the kinetics of serum PCT are not influenced by age, gender or renal function (because only a proportion of PCT is excreted by the kidneys).…”

Section: Introductionmentioning

confidence: 99%

Procalcitonin and intestinal ischemia: A review of the literature

Cossé¹,

Sabbagh²,

Kamel³

et al. 2014

WJG

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Intestinal ischemia is common after emergency gastrointestinal or cardiovascular surgery. At present, there are no diagnostic tools for the early diagnosis of intestinal ischemia. In the last decade, procalcitonin (PCT) has been suggested as a marker of this condition. Here, we review the use of PCT as a diagnostic tool for intestinal ischemia. Two reviewers independently searched the PubMed and EMBASE databases for articles on intestinal ischemia and PCT. They then considered (1) the criteria applicable to preclinical and clinical data; and (2) PCT's predictive value in the diagnosis of intestinal ischemia. Article quality was rated according to the STAndards for Reporting of Diagnostic accuracy. Between 1993 and 2014, seven studies (including two preclinical studies and five clinical studies) dealt with the use of PCT to diagnose intestinal ischemia. Procalcitonin's sensitivity, specificity, positive predictive value and negative predictive value ranged between 72% and 100%; 68% and 91%; 27% and 90% and 81% and 100%, respectively. The area under the receiver operating characteristic curve ranged from 0.77 to 0.92. In view of the preclinical and clinical data, we consider that PCT can be used in daily practice as a tool for diagnosing intestinal ischemia.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Procalcitonin; Intestinal; Ischemia; Diagnosis; Review Core tip: The serum procalcitonin level is clinically relevant for the diagnosis of intestinal ischemia. In the diagnosis of intestinal ischemia, procalcitonin's sensitivity is greater than 70% and its negative predictive value is greater than 80%.

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“…An increase in PCT values after CPB, in the absence of postoperative infection, has previously been reported by Meisner et al [22]. Moreover, PCT values greater than 2 ng/mL can be observed in case of systemic inflammatory response syndrome after CPB, without any postoperative infectious complication [23,24]. …”

Section: Discussionmentioning

confidence: 72%

Relevance of Endothelial Cell-Specific Molecule 1 (Endocan) Plasma Levels for Predicting Pulmonary Infection after Cardiac Surgery in Chronic Kidney Disease Patients: The Endolung Pilot Study

Perrotti¹,

Chenevier‐Gobeaux

Ecarnot³

et al. 2017

Cardiorenal Med

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Objectives: This pilot study aimed to evaluate the relevance of endocan plasma levels for predicting pulmonary infection after cardiac surgery in patients with chronic kidney disease (CKD). Methods: Serum collected in a previous prospective cohort study (from 166 patients with preoperative CKD who underwent cardiac surgery) was used. Five patients with postoperative pulmonary infection were compared with 15 randomly selected CKD patients with an uneventful outcome. Blood samples were tested at 4 time points (preoperatively and 6, 12, and 24 h after the end of surgery). Endocan, procalcitonin, and C-reactive protein plasma levels were compared between the two groups. Results: At 6 h, the patients with pulmonary infection had significantly higher levels of endocan than the patients without pulmonary infection (24.2 ± 15.6 vs. 6.4 ± 3.2 ng/mL; p = 0.03). A receiver operating characteristic curve analysis showed 80% sensitivity and 100% specificity for endocan to predict pulmonary infection (area under the curve 0.84), with a cutoff value of 15.9 ng/mL. The time saved by assessment of the endocan dosage compared to a clinical diagnosis of pulmonary infection was 47 h. Conclusion: This pilot study showed that a specific study to assess the link between endocan plasma levels and pulmonary infection after cardiac surgery in CKD patients is of potential utility.

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Postoperative plasma concentrations of procalcitonin after different types of surgery

Cited by 363 publications

References 8 publications

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Procalcitonin and intestinal ischemia: A review of the literature

Relevance of Endothelial Cell-Specific Molecule 1 (Endocan) Plasma Levels for Predicting Pulmonary Infection after Cardiac Surgery in Chronic Kidney Disease Patients: The Endolung Pilot Study

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