Procalcitonin kinetics in pediatric patients with systemic inflammatory response after open heart surgery
Intensive Care Medicine, cilt.32, sa.6, ss.881-887, 2006 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 6
- Basım Tarihi: 2006
- Doi Numarası: 10.1007/s00134-006-0180-z
- Dergi Adı: Intensive Care Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.881-887
- Anahtar Kelimeler: inflammation, organ failure, pediatric heart surgery, procalcitonin, C-reactive protein
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: To evaluate procalcitonin and C-reactive protein as markers of inflammation severity and their value in predicting development of organ failure after pediatric open heart surgery. Design: Prospective, observational, clinical study. Setting: Single university hospital. Patients: Thirty-three pediatric patients with systemic inflammatory response syndrome (SIRS; n = 19) and SIRS+organ failure (SIRS+OF; n = 14) following open heart surgery were included. Measurements and results: Plasma procalcitonin and C-reactive protein levels were measured before and after the operation, and 1, 2, 3, and 4 days after surgery. Patients were evaluated daily to assess organ failure. Postoperative procalcitonin levels in the SIRS+OF group were significantly higher than in the SIRS group. C-reactive protein levels were similar between the groups throughout the study period. Peak procalcitonin levels were found to be positively correlated with aortic cross-clamp and cardiopulmonary bypass times, duration of mechanical ventilation, intensive care unit and hospital stay, mortality and organ failure development. Peak procalcitonin was found to be a good predictor of postoperative organ failure development and mortality. However, the predictive value of peak C-reactive protein for organ failure and mortality was found to be weak. Double-peak procalcitonin curves were observed in SIRS+OF patients with infection during the intensive care unit stay. Conclusion: In the SIRS+OF group peak procalcitonin levels were found to be highly predictive for mortality and organ failure development, whereas C-reactive protein levels were not. Daily procalcitonin measurements in SIRS+OF patients may help identify the postoperative infection during the follow-up period. © Springer-Verlag 2006.