Quantitative analysis of procalcitonin after pediatric cardiothoracic surgery
- 1 January 2006
- journal article
- research article
- Published by Cambridge University Press (CUP) in Cardiology in the Young
- Vol. 16 (1), 48-53
- https://doi.org/10.1017/s1047951105002088
Abstract
Procalcitonin appears to be an early and sensitive marker of bacterial infection in a variety of clinical settings. The use of levels of procalcitonin to predict infection in children undergoing cardiac surgery, however, may be complicated by the systemic inflammatory response that normally accompanies cardiopulmonary bypass. The aim of our study was to estimate peri-operative concentrations of procalcitonin in non-infected children undergoing cardiac surgery. Samples of serum for assay of procalcitonin were obtained in 53 patients at baseline, 24, 48, and 72 hours following cardiac surgery. Concentrations were assessed using an immunoluminetric technique. Median concentrations were lowest at baseline at less than 0.5 nanograms per millilitre, increased at 24 hours to 1.8 nanograms per millilitre, maximized at 48 hours at 2.1 nanograms per millilitre, and decreased at 72 hours to 1.3 nanograms per millilitre, but did not return to baseline levels. Ratios of concentrations between 24, 48 and 72 hours after surgery as compared to baseline were 6.15, with 95 percent confidence intervals between 4.60 and 8.23, 6.49, with 95 percent confidence intervals from 4.55 to 9.27, and 4.26, with 95 percent confidence intervals between 2.78 and 6.51, respectively, with a p value less than 0.001. In 8 patients, who had no evidence of infection, concentrations during the period from 24 to 72 hours were well above the median for the group. We conclude that concentrations of procalcitonin in the serum increase significantly in children following cardiac surgery, with a peak at 48 hours, and do not return to baseline within 72 hours of surgery. A proportion of patients, in the absence of infection, had exaggerated elevations post-operatively.Keywords
This publication has 28 references indexed in Scilit:
- Procalcitonin is a Valuable Prognostic Marker in Cardiac Surgery but not Specific for InfectionThe Thoracic and Cardiovascular Surgeon, 2003
- Comparison of procalcitonin and C-reactive protein as markers of sepsisCritical Care Medicine, 2003
- Hyperprocalcitonemia in patients with perioperative myocardial infarction after cardiac surgeryCritical Care Medicine, 2001
- Usefulness of procalcitonin for diagnosis of infection in cardiac surgical patientsCritical Care Medicine, 2000
- Procalcitonin as a Marker of Systemic Inflammation After Conventional or Minimally Invasive Coronary Artery Bypass GraftingThe Thoracic and Cardiovascular Surgeon, 1998
- Reliability of Procalcitonin Concentrations for the Diagnosis of Sepsis in Critically III NeonatesClinical Infectious Diseases, 1998
- Procalcitonin: a new parameter for the diagnosis of bacterial infection in the peri-operative periodEuropean Journal of Anaesthesiology, 1998
- Procalcitonin and C‐reactive protein levels in neonatal infectionsActa Paediatrica, 1997
- Hemangioma of the esophagusThe Annals of Thoracic Surgery, 1996
- Procalcitonin increase after endotoxin injection in normal subjectsJournal of Clinical Endocrinology & Metabolism, 1994