Procalcitonin used as a marker of infection in the intensive care unit

Ugarte, Héctor; Silva, Eliézer; Mercan, Dany; Mendonça, Arnaldo de; Vincent, Jean‐Louis

doi:10.1097/00003246-199903000-00024

Cited by 367 publications

(255 citation statements)

References 17 publications

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“…-Procalcitonin has been proposed as a marker of infection [60][61][62][63]. Furthermore, it may be useful as an indicator of the severity of infection and as a guide for therapy (dose de-escalation [64]) in respiratory infections [61,62,[65][66][67][68].…”

Section: The Diagnosis Of Sepsismentioning

confidence: 99%

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Mirabile

Numico²,

Russi

et al. 2015

Critical Reviews in Oncology/Hematology

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The reporting of infection/sepsis in chemo/radiation-treated head and neck cancer patients is sparse and the problem is underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met with the aim of reaching a consensus on a clinical definition and management of infections and sepsis. The Delphi appropriateness method was used for this consensus. External expert reviewers then evaluated the conclusions carefully according to their area of expertise. The paper contains seven clusters of statements about the clinical definition and management of infections and sepsis in head and neck cancer patients, which had a consensus. Furthermore, it offers a review of recent literature in these topics

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Section: The Diagnosis Of Sepsismentioning

confidence: 99%

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Mirabile

Numico²,

Russi

et al. 2015

Critical Reviews in Oncology/Hematology

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“…Performance of some biological markers of sepsis. 10,24,25 acute phase reactants have been described in sepsis, however none are specific enough for infection, as all can be increased in other inflammatory conditions without obvious infection (table 3).…”

Section: Strem-1: the Biological Marker Of Infection?mentioning

confidence: 99%

“…[6][7][8] However, several investigators have questioned the diagnostic and prognostic accuracy of routine procalcitonin measurements, reporting inconsistent and variable results depending on the severity of illness and degree of infection in the patient population studied. [9][10][11] The triggering receptor expressed on myeloid cells-1 (TREM-1) is a recently discovered member of the immunoglobulin superfamily. 12 Like other similar cell-surface receptors, TREM-1 has a short intracellular domain and, when bound to its as yet unidentified ligand, associates with a signal-transduction molecule, DAP12, triggering the secretion of inflammatory cytokines that amplify the host response to microbial agents.…”

Section: Introductionmentioning

confidence: 99%

Soluble Form of the Triggering Receptor Expressed on Myeloid Cells-1 as a Marker of Microbial Infection

Gibot¹,

Cravoisy²

2004

Clinical Medicine & Research

117

114

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Sepsis is a common cause of morbidity and mortality in intensive care units. Unfortunately, there is no gold standard for diagnosing sepsis as clinical and laboratory signs are neither sensitive enough nor specific enough, and microbiological studies often remain negative. Thus, there is a need for clinical or laboratory tools to distinguish between sepsis and non-infectious inflammatory disorders. Among the potentially useful markers of sepsis, procalcitonin has been suggested to be the most promising, although results are variable depending on the severity of illness and degree of infection in the patient population studied. The triggering receptor expressed on myeloid cells-1 (TREM-1) is a member of the immunoglobulin superfamily, of which expression is upregulated on phagocytic cells in the presence of bacteria or fungi. Here we report on the potential usefulness of assessing the soluble form of TREM-1 (sTREM-1) in biological fluids for the diagnosis of microbial infection.

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“…PCT was found to be an accurate diagnostic parameter for differentiating SIRS and sepsis [5]. Previously, PCT was reported to be a better discriminator than CRP in characterizing the degree of inflammation related to infection [17], especially infection complicated by sepsis or organ failure [18]. With this background, PCT has been proposed as a better prognostic marker than CRP [19,20].…”

Section: Discussionmentioning

confidence: 99%

Value of Serum Procalcitonin in Evaluating the Prognosis of Sepsis in Elderly Patients with Colorectal Cancer Undergoing Emergency Colorectal Surgery

Zou

Cai

et al. 2012

Indian J Surg

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Serum procalcitonin (PCT) levels may have predictive value in the prognosis of postoperative sepsis in elderly patients who have undergone colorectal surgery for colorectal cancer in intensive care units (ICUs). A prospective study involving 90 critically ill patients who underwent colorectal surgery for colorectal cancer in ICUs was performed. Twenty-eight patients were diagnosed with sepsis, in accordance with the American College of Chest Physicians/Society of Critical Care Medicine consensus criteria, and these patients were included in the sepsis group. Sixtytwo patients, who were without evidence of sepsis, were enrolled in the control group. We measured the serum PCT concentrations preoperatively (immediately before induction of anesthesia), upon arrival in the ICU (ICU day 0), on the morning of the first postoperative day (postoperative day 1), and on the morning of the third postoperative day (postoperative day 3). The C-reactive protein (CRP) index, acute physiology and chronic health evaluation II (APACHE II) score, mechanical duration of ventilation, mortality rate, incidence of multiple organ failure, and usage of continuous renal replacement therapy were evaluated. The area under the curve for the receiver operating characteristic curve (AUC-ROCC) was measured to explore the association between the serum PCT and the prognosis. In the sepsis group, 12/28 patients died (mortality rate 43 %). In the control group, 6/ 62 patients died (mortality rate 9.7 %). On the first postoperative day, the serum PCT level was dramatically higher in the sepsis group than in the control group (2.71±1.13 vs. 1.37± 0.57, P≤0.05). The PCT level on the first postoperative day was distinctly higher than that measured upon arrival in the ICU (2.71±1.13 vs. 1.31±0.58, P≤0.05). In the two groups, the CRP concentrations were both markedly higher on the first postoperative day than upon arrival in the ICU (138.89±45.12 vs. 70.43±23.54 in the sepsis group, and 133.13±44.91 vs. 69.65±24.98 in the control group, P≤0.05). Linear regression analysis was performed. The results suggest that the PCT and APACHE-II scores were not significantly associated. On the first and third postoperative days, the PCT levels were associated with increased odds of sepsis (AUC-ROCC, 95 % confidence interval 0.817-0.973, P 00.000, and 0.755-0.944, P00.000, respectively). The outcomes of patients in the sepsis group were worse than those in the control group. PCT levels appear to be early markers of postoperative sepsis in elderly patients undergoing colorectal surgery for colorectal cancer during the ICU course. These findings could allow for early identification of postoperative septic complications and be used for prognostic evaluation of these patients.

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Procalcitonin used as a marker of infection in the intensive care unit

Abstract: ProCT is not a better marker of infection than CRP in critically ill patients, but it can represent a useful adjunctive parameter to identify infection and is a useful marker of the severity of infection.

Cited by 367 publications

References 17 publications

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Soluble Form of the Triggering Receptor Expressed on Myeloid Cells-1 as a Marker of Microbial Infection

Value of Serum Procalcitonin in Evaluating the Prognosis of Sepsis in Elderly Patients with Colorectal Cancer Undergoing Emergency Colorectal Surgery

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