The utility of procalcitonin in critically ill trauma patients

Sakran, Joseph V.; Michetti, Christopher P.; Sheridan, Michael J.; Richmond, Robyn; Waked, Tarek; Aldaghlas, Tayseer A.; Rizzo, Anne G.; Griffen, Margaret M.; Fakhry, Samir M.

doi:10.1097/ta.0b013e31825ff5b7

Cited by 56 publications

(48 citation statements)

References 35 publications

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“…This findings was supported by another study in trauma patients where complications such as sepsis, infection, blood transfusion, prolonged ICU treatment, and poor outcome were more frequent in patients with initially high PCT (>1 ng/ml), whereas CRP shows no positive correlation. [26,27] Favorable outcome was seen in patients with low PCT levels. This finding is consistent with the result seen in another study where decrease of serum PCT within the first 48 hours by 30% or its persistence at levels lower than 0.25 ng/ml was an indicator of favorable outcome.…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin as a Predictor of Sepsis and Outcome in Severe Trauma Patients: A Prospective Study

et al. 2013

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Introduction:Despite the advances in medical sciences, the morbidity and mortality due to sepsis in severe trauma patients remains high; hence the need for early and accurate diagnosis. Very few prospective studies are available in a country like India, which tried to analyze the prediction of sepsis using serum procalcitonin (PCT) in such a large scale among trauma patients. This study explores the role of the biomarker PCT in early diagnosis of sepsis and prediction of outcomes in severe trauma cases.Materials and Methods:We studied the patient population prospectively in two different groups. One with acute trauma but no clinical evidence of sepsis and the second group with clinical evidence of sepsis and are followed. Bronchoalveolar lavage, tracheal aspirates, pus, urine, body fluids from sterile body sites, etc., were collected including blood for culture and serum for PCT assays. Such assays were done on samples collected on days 1 and 4 and then compared. Additionally, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were also tested. Antimicrobial sensitivity tests were carried out for all the isolates from the clinical samples and correlated with the clinically suspected cases of sepsis. Outcomes of the patients were noted.Results:Patients with high initial PCT levels (>2 ng/ml) in severe trauma cases had poor outcomes and risk of developing complications. Its correlation with severe outcomes was better marked as compared with CRP and ESR levels. The difference in PCT levels between days 1 and 4 in group two patients was statistically significant (P = 0.006) but were not statistically significant for CRP (P = 0.646) and ESR (P = 0.935). The study also shows that PCT levels fall in response to appropriate antimicrobial treatment.Conclusion:PCT is a useful biomarker for early and accurate prediction of sepsis in severe trauma patients. If used in adjunct to clinical findings, it proves to be a good biomarker for early diagnosis, treatment and for monitoring response to therapy in confirmed cases of sepsis. It will prove to be a good supportive indicator of sepsis in early stages for the trauma patients in a low resource country like India.

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Section: Discussionmentioning

confidence: 99%

Procalcitonin as a Predictor of Sepsis and Outcome in Severe Trauma Patients: A Prospective Study

et al. 2013

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“…The study of PCT should also be performed in dynamics during the first week after the onset of the disease or trauma, taking into account both our data and scientific literature indicating that high concentration of PCT starting with the first day after the onset of the disease or severe trauma and its secondary rise are precursors of the development of sepsis and/or multi-organ failure [17,18].…”

Section: Results and Descussionmentioning

confidence: 99%

Dynamics of Systemic Inflammatory Response Markers in Patients With Urgent Conditions Depend-Ing on the Development of Sepsis

Bulava¹,

Шабанов²,

Nikitina³

et al. 2018

Neotložnaâ med. pomoŝʹ

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“…[24] PCT has been shown to be a marker of bacterial infection and sepsis[25,26] as PCT is released systemically from various types of cells outside the thyroid as a response to bacterial infection. [27] On the condition of systemic bacterial infection or by stimulation with endotoxin or proinflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-1, PCT levels increase 1,000 times within a few hours. [28,29] The half-life of PCT, approximately 22 h, is another characteristic that can be used as a biomarker for bacterial infection.…”

Section: Biomarkersmentioning

confidence: 99%

“…[4] Continuous high levels or secondary increases of PCT are predictors of sepsis. [27,28,30–34] PCT as a biomarker is useful in the prediction and early diagnosis of sepsis in trauma patients. Currently, PCT is already used in clinical practice, and it is used to guide antibiotic therapy in patients with lower respiratory tract infections or other infections such as fungal infections, postoperative fever and suspected bloodstream infections.…”

Section: Biomarkersmentioning

confidence: 99%

Prediction of sepsis in trauma patients

Liu

Xiao

et al. 2014

Burn Trauma

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Trauma is one of the leading causes of death worldwide. Approximately 39.5% of deaths occur in the hospital, and the mortality rate of delayed death caused by septic complications is still high. Early prediction of the development of sepsis can help promote early intervention and treatment for patients and contribute to improving patient outcomes. Thus so far, biomarkers, patient demographics and injury characteristics are the main methods used for predicting sepsis in trauma patients. However, studies that verify their predictive value are limited, and the results are still controversial. More work should be conducted to explore more efficient and accurate ways to predict post-traumatic sepsis.

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The utility of procalcitonin in critically ill trauma patients

Cited by 56 publications

References 35 publications

Procalcitonin as a Predictor of Sepsis and Outcome in Severe Trauma Patients: A Prospective Study

Procalcitonin as a Predictor of Sepsis and Outcome in Severe Trauma Patients: A Prospective Study

Dynamics of Systemic Inflammatory Response Markers in Patients With Urgent Conditions Depend-Ing on the Development of Sepsis

Prediction of sepsis in trauma patients

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