Plasma Procalcitonin And C-Reactive Protein In Acute Septic Shock: Clinical And Biological Correlates

Author(s):  
R. Claeys ◽  
S. Vinken ◽  
H. Spapen ◽  
K. ver Elst ◽  
L. Huyghens ◽  
...  
2020 ◽  
Vol 87 (3-4) ◽  
pp. 14-17
Author(s):  
O. V. Rotar ◽  
I. V. Khomiak ◽  
V. I. Rotar ◽  
A. I. Khomiak ◽  
S. I. Railianu

Objective. To conduct comparative estimation of efficacy of C-reactive protein and procalcitonin as laboratory markers for stratification of the patients severity state suffering an acute necrotic pancreatitis. Materials and methods. Prospective cohort investigation, including 151 patients with an acute necrotic pancreatitis, was conducted. Clinical, laboratory and bacteriological investigations were accomplished. The levels of C-reactive protein and procalcitonin were determined in the blood plasm. Results. The necrotic accumulations infectioning was diagnosed in 89 (58.9%) patients: local purulent complications - in 27, sepsis - in 33,septic shock - in 29. In 62 patients with sterile pancreonecrosis a C-reactive protein concentration have raised from (5.6 ± 0.89) to (206 ± 29) mg/l (p˂0.001). Development of purulent-septic complications was accompanied by significant and trustworthy (p<0.01) elevation of procalcitonin concentration: in the patients with sepsis - up to (5.05 ± 0.92) ng/ml, in the patients with septic shock - up to (7.25 ± 2.15) ng/ml. Conclusion. Simultaneous measurement of levels of C-reactive protein and procalcitonin in the blood plasm in patients, suffering acute necrotic pancreatitis, gives permission to determine the inflammatory process character and stratify the disease severity in its early terms.


BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026527 ◽  
Author(s):  
Yixuan Zhou ◽  
Zhen Liu ◽  
Jun Huang ◽  
Guiling Li ◽  
Fengying Li ◽  
...  

ObjectivesOur aim was to assess the release level of heparin-binding protein (HBP) in sepsis and septic shock under theThird International Consensus Definitions for Sepsis and Septic Shock(Sepsis-3).DesignProspective cohort study.SettingA general teaching hospital in China.ParticipantsAdult infected patients with suspected sepsis and people who underwent physical examination were included. According to the health status and severity of illness, the research subjects were divided into healthy, local infection, sepsis non-shock and septic shock under Sepsis-3 definitions.Main outcome measuresPlasma levels of HBP, procalcitonin (PCT), C reactive protein (CRP) and complete blood count were detected in all subjects. Single-factor analysis of variance was used to compare the biomarker levels of multiple groups. A receiver operating characteristic (ROC) curve was used to assess the diagnostic capacity of each marker.ResultsHBP levels were significantly higher in patients with sepsis non-shock than in those with local infections (median 49.7ng/mL vs 11.8 ng/mL, p<0.01) at enrolment. Moreover, HBP levels in patients with septic shock were significantly higher than in patients with sepsis without shock (median 153.8ng/mL vs 49.7 ng/mL, p<0.01). The area under the ROC curve (AUC) of HBP (cut-off ≥28.1 ng/mL) was 0.893 for sepsis which was higher than those of PCT (0.856) for a cut-off ≥2.05 ng/mL and of CRP (0.699) for a cut-off ≥151.9 mg/L. Moreover, AUC of HBP (cut-off ≥103.5 ng/mL) was 0.760 for septic shock which was higher than the ROC curve of sequential [sepsis-related] organ failure assessment (SOFA) Score (0.656) for a cut-off ≥5.5. However, there was no significant difference between 28-d survivors (n=56) and 28-d non-survivors (n=37) with sepsis in terms of HBP value (p=0.182).ConclusionsA high level of HBP in plasma is associated with sepsis, which might be a useful diagnostic marker in patients with suspected sepsis.


2009 ◽  
Vol 127 (6) ◽  
pp. 350-354 ◽  
Author(s):  
Domingos Dias Cicarelli ◽  
Joaquim Edson Vieira ◽  
Fábio Ely Martins Benseñor

CONTEXT AND OBJECTIVE: C-reactive protein (CRP) is commonly used as a marker for inflammatory states and for early identification of infection. This study aimed to investigate CRP as a marker for infection in patients with postoperative septic shock. DESIGN AND SETTING: Prospective, single-center study, developed in a surgical intensive care unit at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS: This study evaluated 54 patients in the postoperative period, of whom 29 had septic shock (SS group) and 25 had systemic inflammatory response syndrome (SIRS group). All of the patients were monitored over a seven-day period using the Sequential Organ Failure Assessment (SOFA) score and daily CRP and lactate measurements. RESULTS: The daily CRP measurements did not differ between the groups. There was no correlation between CRP and lactate levels and the SOFA score in the groups. We observed that the plasma CRP concentrations were high in almost all of the patients. The patients presented an inflammatory state postoperatively in response to surgical aggression. This could explain the elevated CRP measurements, regardless of whether the patient was infected or not. CONCLUSIONS: This study did not show any correlation between CRP and infection among patients with SIRS and septic shock during the early postoperative period.


1999 ◽  
Vol 97 (5) ◽  
pp. 529-538 ◽  
Author(s):  
Annika TAKALA ◽  
Irma JOUSELA ◽  
Sten-Erik JANSSON ◽  
Klaus T. OLKKOLA ◽  
Olli TAKKUNEN ◽  
...  

To obtain predictors of organ failure (OF), we studied markers of systemic inflammation [circulating levels of interleukin-6 (IL-6), IL-8, soluble IL-2 receptor (sIL-2R), soluble E-selectin and C-reactive protein, and neutrophil and monocyte CD11b expression] and routine blood cell counts in 20 patients with systemic inflammatory response syndrome and positive blood culture. Eight patients with shock due to community-acquired infection developed OF, whereas 11 normotensive patients and one patient with shock did not (NOF group). The first blood sample was collected within 48 h after taking the blood culture (T1). OF patients, as compared with NOF patients, had at T1 a lower monocyte count, a lower platelet count, higher levels of CD11b expression on both neutrophils and monocytes, and higher concentrations of IL-6, IL-8 and sIL-2R. C-reactive protein and soluble E-selectin concentrations did not differ between groups. No parameter alone identified all patients that subsequently developed OF. However, a sepsis-related inflammation severity score (SISS), developed on the basis of the presence or absence of shock and on the levels of markers at T1, identified each patient that developed OF. The maximum SISS value was 7. The range of SISS values in OF patients was 2–5, and that in NOF patients was 0–1. In conclusion, high levels of CD11b expression, depressed platelet and monocyte counts, and high concentrations of IL-6, IL-8 and sIL-2R predict OF in patients with community-acquired septic shock, and the combination of these markers may provide the means to identify sepsis patients who will develop OF.


2008 ◽  
Vol 2008 ◽  
pp. 1-5 ◽  
Author(s):  
Domingos Dias Cicarelli ◽  
Joaquim Edson Vieira ◽  
Fábio Ely Martins Benseñor

Septic shock is a severe inflammatory state caused by an infectious agent. Our purpose was to investigate serum amyloid A (SAA) protein and C-reactive protein (CRP) as inflammatory markers of septic shock patients. Here we evaluate 29 patients in postoperative period, with septic shock, in a prospective study developed in a surgical intensive care unit. All eligible patients were monitored over a 7-day period by sequential organ failure assessment (SOFA) score, daily CRP, SAA, and lactate measurements. CRP and SAA strongly correlated up to the fifth day of observation but were not good predictors of mortality in septic shock.


2002 ◽  
Vol 30 (4) ◽  
pp. 757-762 ◽  
Author(s):  
Roxane Claeys ◽  
Stephanie Vinken ◽  
Herbert Spapen ◽  
Kristien ver Elst ◽  
Katelyn Decochez ◽  
...  

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