Procalcitonina como biomarcador de prognóstico da sepse grave e choque séptico

Azevedo, José Raimundo A. de; Torres, Orlando Jorge Martins; Czeczko, Nicolau Gregori; Tuon, Felipe Francisco; Nassif, Paulo Afonso Nunes; Souza, Gleim Dias de

doi:10.1590/s0100-69912012000600003

Cited by 34 publications

(17 citation statements)

References 27 publications

(30 reference statements)

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“…In 28 patients with severe sepsis/septic shock from Brazil, Azevedo et al . [ 14 ] found that the procalcitonin level after 24–48 h was significantly different among survivors and NS (median 8.2 ng/ml vs. 68.6 ng/ml at 24 h and 4.6 ng/ml and 31 ng/ml at 48 h among survivors and NS respectively). Similar findings were obtained by Suberviola et al .…”

Section: Discussionmentioning

confidence: 99%

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Procalcitonin kinetics as a prognostic marker in severe sepsis/septic shock

Poddar

Gurjar

Singh

et al. 2015

Indian Journal of Critical Care Medicine

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Background and Aims:To evaluate the prognostic value of change (fall) in serum procalcitonin level (PCT) in critically ill adults with severe sepsis/septic shock.Methods:This was a prospective observational study in a general purpose Intensive Care Unit of a teaching Institute. PCT was measured at admission (D0) and after 72–96 h (D4) by electrochemi-luminescence immunoassay (BRAHMS PCT kit) in adults (>18 years) admitted with severe sepsis or septic shock. Change in procalcitonin values from D0 to D4 was correlated with the primary outcome, that is, 28 days mortality. All results are reported as median (interquartile range).Results:A total of 171 (100 males) of 181 patients were included. The median age was 46 years (range 19–79). 137 patients were in septic shock and 34 in severe sepsis. The sequential organ failure assessment (SOFA) score in all patients was 11 (9–14).91 (53.2%) patients survived at 28 days (survivors). The baseline procalcitonin was similar in two groups (3.48 [1.04–15.85] vs. 5.27 [1.81–23.57] ng/ml in survivors and nonsurvivors [NS] respectively). The procalcitonin change was 1.58 (0.20–8.52) in survivors and 0.28 (–1.38–6.17) in NS (P = 0.01). The C-statistic of percentage change in procalcitonin from D0 to D4 to predict survival was 0.73 (95% confidence interval [CI]: 0.65–0.82) when compared to 0.78 (95% CI: 0.71–0.86) for change of SOFA score. For an absolute fall in procalcitonin of >1 ng/ml, a 70% fall predicted survival with 75% sensitivity and 64% specificity.Conclusions:In critically ill-patients with severe sepsis/septic shock, change (fall) in procalcitonin is associated with good outcome.

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Section: Discussionmentioning

confidence: 99%

“…Similarly, in 28 patients with severe sepsis/septic shock, Azevedo et al . [ 14 ] found procalcitonin clearance at 24 h was significantly higher among survivors as compared to NS ( P = 0.028). Suberviola et al .…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin kinetics as a prognostic marker in severe sepsis/septic shock

Poddar

Gurjar

Singh

et al. 2015

Indian Journal of Critical Care Medicine

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“…in infant populations. [1920] Azevedo et al . showed a higher level of procalcitonin in sepsis and severe sepsis in adult patients were related to increase risk mortality.…”

Section: Discussionmentioning

confidence: 99%

“…showed a higher level of procalcitonin in sepsis and severe sepsis in adult patients were related to increase risk mortality. [19] In the neonatus population, the level of procalcitonin can be used as a marker for early detection of sepsis in the intensive care unit. [2120] As a sepsis marker in the neonatus, procalcitonin is better than C-Reactive Protein (CRP);[21] however, CRP can be used as a marker for bacterial co-infection in the viral-induced bronchiolitis infant populations.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic resistance in sepsis patients: Evaluation and recommendation of antibiotic use

et al. 2013

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Background:The appropriate selection of empirical antibiotics based on the pattern of local antibiotic resistance can reduce the mortality rate and increase the rational use of antibiotics.Aims:We analyze the pattern of antibiotic use and the sensitivity patterns of antibiotics to support the rational use of antibiotics in patients with sepsis.Materials and Methods:A retrospective observational study was conducted in adult sepsis patient at one of Indonesian hospital during January-December 2011. Data were collected from the hospital medical record department. Descriptive analysis was used in the processing and interpretation of data.Results:A total of 76 patients were included as research subjects. Lung infection was the highest source of infection. In the 66.3% of clinical specimens that were culture positive for microbes, Klebsiella pneumoniae, Escherichia coli, Staphylococcus hominis were detected with the highest frequency. The six most frequently used antibiotics, levofloxacin, ceftazidime, ciprofloxacin, cefotaxime, ceftriaxone, and erythromycin, showed an average resistance above 50%.Conclusions:The high use of antibiotic with a high level resistance requires a policy to support its rational use. Local microbial pattern based on site infection and pattern of antibiotics sensitivity test can be used as supporting data to optimize appropriateness of empirical antibiotics therapy in sepsis patients.

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“…The researchers suggested that serial lactate and ProCT measurements may be used together to enhance the results (Phua et al, 2008). Other studies showed that ProCT is elevated in patients with sepsis, which qualified ProCT as an acceptable biomarker (Azevedo et al, 2012;Becker, Snider, & Nylen, 2010;Kibe, Adams, & Barlow, 2011;McLean, Tang, & Huang, 2015;Riedel, 2012). Shapiro et al (2009) defined a panel of biomarkers consisting of neutrophil gelatinase-associated lipocalin, interleukin-1ra, and Protein C. This panel of biomarkers was a good predictor of severe sepsis, septic shock, and death of patients with suspected sepsis in Emergency Departments (Shapiro et al, 2009).…”

Section: Septic Shock Biomarkersmentioning

confidence: 99%