Procalcitonin als Instrument zur Erfolgsmessung der Therapie einer schweren Sepsis

Bodmann, Klaus-Friedrich; Schenker, Michael; Heinlein, Wolfgang; Wilke, Michael

doi:10.1007/s00063-016-0183-7

Cited by 6 publications

(1 citation statement)

References 28 publications

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“…This study aims to design and develop a cost-effective immunoassay system based on TR-FRET technology, focusing on the multiplexed detection of novel inflammatory biomarkers [ 22 , 23 ], including Procalcitonin (PCT) [ 24 , 25 , 26 ], C-Reactive Protein (CRP) [ 27 ], Serum Amyloid A (SAA), and Interleukin-6 (IL-6). These biomarkers play crucial roles in the early diagnosis and treatment of inflammation-related diseases.…”

Section: Introductionmentioning

confidence: 99%

Immunoassay System Based on the Technology of Time-Resolved Fluorescence Resonance Energy Transfer

Xu,

Zhou,

et al. 2024

Sensors

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To enhance the specificity and sensitivity, cut the cost, and realize joint detection of multiple indicators, an immunoassay system based on the technology of time-resolved fluorescence resonance energy transfer (TR-FRET) was studied. Due to the FRET of the reagent, the donor probe and acceptor probe emitted specific fluorescence to enhance specificity. Long-lifetime specific fluorescence from the acceptor probe was combined with time-resolved technology to enhance sensitivity. A xenon flash lamp and a photomultiplier tube (PMT) were selected as the light source and detector, respectively. A filter-switching mechanism was placed in the light path, so the fluorescence signal from the donor and acceptor was measured alternately. The instrument’s design is given, and some specificI parts are described in detail. Key technical specifications of the instrument and procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6(IL-6) were tested, and the test results were presented subsequently. The CV value of the self-designed counting module is better than 0.01%, and the instrument noises for 620 nm and 665 nm are 41.44 and 10.59, respectively. When set at 37 °C, the temperature bias (B) is 0.06 °C, and the temperature fluctuation is 0.10 °C. The CV and bias are between ±3% and 5%, respectively, when pipetting volumes are between 10 μL and 100 μL. Within the concentration range of 0.01 nM to 10 nM, the luminescence values exhibit linear regression correlation coefficients greater than 0.999. For PCT detection, when the concentration ranges from 0.02 ng/mL to 50 ng/mL, the correlation coefficient of linear fitting exceeds 0.999, and the limit of quantification is 0.096 ng/mL. For CRP and IL-6, the detection concentration ranges from 0 ng/mL to 500 ng/mL and 0 ng/mL to 20 ng/mL, respectively, with limits of quantification of 2.70 ng/mL and 2.82 ng/mL, respectively. The experimental results confirm the feasibility of the technical and instrumental solutions.

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Section: Introductionmentioning

confidence: 99%

Immunoassay System Based on the Technology of Time-Resolved Fluorescence Resonance Energy Transfer

Xu,

Zhou,

et al. 2024

Sensors

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S2k-Leitlinie der PEG zur kalkulierten parenteralen Initialtherapie bakterieller Erkrankungen bei Erwachsenen

et al. 2018

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Adherence to a procalcitonin-guided antibiotic treatment protocol in patients with severe sepsis and septic shock

Höhn

Balfer

Heising

et al. 2018

Ann. Intensive Care

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BackgroundIn randomised controlled trials, procalcitonin (PCT)-guided antibiotic treatment has been proven to significantly reduce length of antibiotic therapy in intensive care unit (ICU) patients. However, concern was raised on low protocol adherence and high rates of overruling, and thus the value of PCT-guided treatment in real clinical life outside study conditions remains unclear. In this study, adherence to a PCT protocol to guide antibiotic treatment in patients with severe sepsis and septic shock was analysed.MethodsFrom 2012 to 2014, surgical ICU patients with severe sepsis or septic shock were retrospectively screened for PCT measurement series appropriate to make treatment decisions on antibiotic therapy. We compared (1) patients with appropriate PCT measurement series to patients without appropriate series; (2) patients who reached the antibiotic stopping advice threshold (PCT < 0.5 ng/mL and/or decrease to 10% of peak level) to patients who did not reach a stopping advice threshold; and (3) patients who were treated adherently to the PCT protocol to non-adherently treated patients. The groups were compared in terms of antibiotic treatment duration, PCT kinetics, and other clinical outcomes.ResultsOf 81 patients with severe sepsis or septic shock, 14 were excluded due to treatment restriction or short course in the ICU. The final analysis was performed on 67 patients. Forty-two patients (62.7%) had appropriate PCT measurement series. In patients with appropriate PCT series, median initial PCT (p = 0.001) and peak PCT levels (p < 0.001) were significantly higher compared to those with non-appropriate series. In 26 patients with appropriate series, PCT levels reached an antibiotic stopping advice. In 8 of 26 patients with stopping advice, antibiotics were discontinued adherently to the PCT protocol (30.8%). Patients with adherently discontinued antibiotics had a shorter antibiotic treatment (7d [IQR 6–9] vs. 12d [IQR 9–16]; p = 0.002). No differences were seen in terms of other clinical outcomes.ConclusionIn patients with severe sepsis and septic shock, procalcitonin testing was irregular and adherence to a local PCT protocol was low in real clinical life. However, adherently treated patients had a shorter duration of antibiotic treatment without negative clinical outcomes. Procalcitonin peak values and kinetics had a clear impact on the regularity of PCT testing.Electronic supplementary materialThe online version of this article (10.1186/s13613-018-0415-5) contains supplementary material, which is available to authorized users.

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Procalcitonin als Instrument zur Erfolgsmessung der Therapie einer schweren Sepsis

Cited by 6 publications

References 28 publications

Immunoassay System Based on the Technology of Time-Resolved Fluorescence Resonance Energy Transfer

Immunoassay System Based on the Technology of Time-Resolved Fluorescence Resonance Energy Transfer

S2k-Leitlinie der PEG zur kalkulierten parenteralen Initialtherapie bakterieller Erkrankungen bei Erwachsenen

Adherence to a procalcitonin-guided antibiotic treatment protocol in patients with severe sepsis and septic shock

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