Kinetics of procalcitonin, interleukin 6 and C-reactive protein after cardiopulmonary-bypass in children

2003 ◽  
Vol 13 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Maurice Beghetti ◽  
Peter C. Rimensberger ◽  
Afksendiyos Kalangos ◽  
Walid Habre ◽  
Alain Gervaix
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Interleukin 6 ◽  
Early Recognition ◽  
P Value ◽  
Specific Marker ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Valuable Marker ◽  
R Value

Cardiopulmonary bypass induces a generalized inflammatory response, with fever and leukocytes, which is difficult to differentiate from an infection. Recently, procalcitonin has been proposed as an early and specific marker of bacterial infection. The influence of cardiopulmonary bypass on production of procalcitonin, therefore, must be assessed before considering this molecule as a valuable marker of infection after cardiac surgery in children. With this in mind, we measured levels of procalcitonin, interleukin 6, and C-reactive protein before and 6 h, 1, 3 and 5 days after cardiopulmonary bypass, in 25 children undergoing cardiac surgery. Cardiopulmonary-bypass induced a transient increase in procalcitonin, with a peak at 24 h, with a median of 1.13 μg/l, a 25th and 75th interquartile of 0.68–2.25, and a p value of less than 0.001. The value had returned to normal in the majority of the children by the third day after surgery. Peak values correlated with the duration of cardiopulmonary-bypass, with a r-value of 0.58 and a p value of 0.003; cross-clamp time, with a r-value of 0.62 and a p value of 0.001; days of mechanical ventilation, with a r-value of 0.62 and a p value of 0.001; and days of stay in intensive care, with a r-value of 0.68, and a p value of 0.0003. The value returned to normal after 3 days in 83% of the patients. Levels of interleukin 6 and C-reactive protein also increased significantly after surgery, and remained elevated for up to 5 days.Thus, in contrast to other markers, levels of procalcitonin in the serum are only slightly and transiently influenced by cardiopulmonary bypass, and may prove to be useful in the early recognition of an infection subsequent to cardiopulmonary bypass.

scholarly journals Serum C-reactive protein and Pro-Calcitonin as an Indicator in Post-Operative Infection after Hepatobiliary Surgery

2020 ◽  
Vol 3 (1) ◽  
pp. 64-70
Author(s):  
Joshua CC ◽  
Sreejith V ◽  
A. Sreekumar
Keyword(s):  
Serum Albumin ◽  
P Value ◽  
Specific Marker ◽  
Hepatobiliary Surgery ◽  
C Reactive Protein ◽  
Biliary Surgery ◽  
Reactive Protein ◽  
Operative Complications ◽  
Serum Crp ◽  
Post Operative Complications

Background: Major hepato-biliary surgeries carry a high risk for post-operative sepsis. Recent therapeutic advances both medical and surgical have improved early post-operative outcome. Considering the difficulties in diagnosis of infection in critically ill patients an early sensitive  and specific marker for sepsis would be of interest. Studies have shown that C - reactive protein (CRP) and pro calcitonin (PCT) are acute phase reactants and good independent early markers of post-operative sepsis, severe or septic shock. This aspect has not been evaluated in     the hepatobiliary surgeries. More over there is no data available from the Indian sub-continent in this aspect. This study aims to evaluate the efficacy of serum CRP and PCT levels after hepatobiliary surgery for diagnosis of postoperative complication. Subjects and Methods: This is a cross-sectional diagnostic study has conducted in 42 patients who all are satisfying the inclusion criteria. Study duration was From August 2017 to July 2019, conducted on patients between 18-80yrs of age undergoing hepato-biliary surgery, in surgical wards of PK Das Institute     of Medical Sciences. Study variables include age, sex, pre-operative serum albumin level, pre and post-operative S.CRP AND S.PCT levels. On post-operative day 4 and day 7 S.CRP and S.PCT are monitored and its predictability also measured. . Descriptive statistical analysis will be carried out using SPSS (IBM). The p-value of less than 0.05 will be taken as significant. Results: out of 42 patients studied, 30 patients developed post-operative complications. Pre-operative serum C - reactive protein and serum procalcitonin measured compared with pre-operative serum albumin was significant identifying post-operative complications (P-value 0.02). On post-operative day 4 and 7value was significant in post-operative patients with P-value of 0.04 vs. 0.046 respectively. Similarly serum procalcitonin values also were significant on postoperative day (POD) 4 and 7 with P-value of 0.02 and 0.03. Sensitivity and specificity of S.PCT was more compared to S.CRP (92 vs 90% in sensitivity and 100% vs 80% in specificity respectively. This study shows those who were clinically septic post operatively have statistically elevated levels of serum CRP and Procalcitonin. Conclusion: S.PCT is more sensitive and specific as a marker of post operative infection following hepato biliary surgery. Early identification of patients with insidious septic illness allows early therapeutic intervention which may favorably influence outcome.

Interleukin-6 and C-reactive protein during pediatric cardiopulmonary bypass

1995 ◽  
Vol 41 (3) ◽  
pp. 467-469 ◽  
Author(s):  
D Behr ◽  
A Hernvann ◽  
P Pouard ◽  
I Spizzi ◽  
F Leca ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Interleukin 6 ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals The value of hyperbilirubinaemia in the diagnosis of acute appendicitis

2011 ◽  
Vol 93 (3) ◽  
pp. 213-217 ◽  
Author(s):  
Andrew Emmanuel ◽  
Peter Murchan ◽  
Ian Wilson ◽  
Paul Balfe
Keyword(s):  
Acute Appendicitis ◽  
White Cell Count ◽  
Specific Marker ◽  
C Reactive Protein ◽  
Suspected Appendicitis ◽  
Reactive Protein ◽  
Valuable Marker ◽  
The Mean ◽  
Histological Results ◽  
Appendiceal Perforation

INTRODUCTION No reliably specific marker for acute appendicitis has been identified. Although recent studies have shown hyperbilirubinaemia to be a useful predictor of appendiceal perforation, they did not focus on the value of bilirubin as a marker for acute appendicitis. The aim of this study was to determine the value of hyperbilirubinaemia as a marker for acute appendicitis. MATERIALS AND METHODS A retrospective analysis of appendicectomies performed in two hospitals (n=472). Data collected included laboratory and histological results. Patients were grouped according to histology findings and comparisons were made between the groups. RESULTS The mean bilirubin levels were higher for patients with simple appendicitis compared to those with a non-inflamed appendix (p<0.001). More patients with simple appendicitis had hyperbilirubinaemia on admission (30% vs 12%) and the odds of these patients having appendicitis were over three times higher (odds ratio: 3.25, p<0.001). Hyperbilirubinaemia had a specificity of 88% and a positive predictive value of 91% for acute appendicitis. Patients with appendicitis who had a perforated or gangrenous appendix had higher mean bilirubin levels (p=0.01) and were more likely to have hyperbilirubinaemia (p<0.001). The specificity of hyperbilirubinaemia for perforation or gangrene was 70%. The specificities of white cell count and C-reactive protein were less than hyperbilirubinaemia for simple appendicitis (60% and 72%) and perforated or gangrenous appendicitis (19% and 36%). CONCLUSIONS Hyperbilirubinaemia is a valuable marker for acute appendicitis. Patients with hyperbilirubinaemia are also more likely to have appendiceal perforation or gangrene. Bilirubin should be included in the assessment of patients with suspected appendicitis.

scholarly journals Autologinio kraujo, išsiskyrusio po širdies operacijos, išsaugojimo ir ankstyvos reinfuzijos įvertinimas

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Audronė Veikutienė ◽  
Rimantas Benetis ◽  
Edmundas Širvinskas ◽  
Pranas Grybauskas ◽  
Judita Andrejaitienė ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Blood Loss ◽  
Leucocyte Count ◽  
C Reactive Protein ◽  
Hospital Department ◽  
Allogeneic Transfusion ◽  
Reactive Protein ◽  
Group I ◽  
Group Ii

Audronė Veikutienė1, Rimantas Benetis1, Edmundas Širvinskas2, Pranas Grybauskas3, Judita Andrejaitienė2, Vincentas Veikutis2, Jonas Šurkus41 Kauno medicinos universiteto klinikų Širdies,krūtinės ir kraujagyslių chirurgijos klinika, Eivenių g. 2, LT-50009 Kaunas2 Kauno medicinos universiteto Biomedicininių tyrimų institutas, Eivenių g. 2, LT-50009 Kaunas3 Kauno medicinos universiteto Kardiologijos institutas, Eivenių g. 2, LT-50009 Kaunas4 Kauno medicinos universiteto klinikų Nefrologijos klinika, Eivenių g. 2, LT-50009 KaunasEl paštas: [email protected] Įvadas / tikslas Įvairūs metodai yra siūlomi alogeninio kraujo poreikiui po širdies operacijų sumažinti. Šio darbo tikslas – nustatyti, ar tikslinga naudoti reinfuzijai autologinį kraują, ištekėjusį ankstyvuoju pooperaciniu laikotarpiu, atsižvelgiant į reinfuzijos įtaką ligos pooperacinei eigai. Ligoniai ir metodai Ištirta 90 ligonių, kuriems atliktos širdies operacijos naudojant dirbtinę kraujo apytaką. Tiriamieji suskirstyti į dvi grupes. Pirmą grupę (n = 41) sudarė ligoniai, kuriems po operacijos per 4 valandas į kardiotominį rezervuarą išsiskyręs kraujas buvo surenkamas į sterilius plastikinius maišelius, centrifuguojamas, o gauti autologiniai eritrocitai grąžinami ligoniui. Antros grupės (n = 49) ligoniams išsiskyręs autologinis kraujas nebuvo grąžinamas. Palyginome hemoglobino, hematokrito, leukocitų, C reaktyviojo baltymo vertes prieš operaciją, po operacijos praėjus 4 val., 20 val. ir penktą parą. Tyrėme prokalcitonino koncentraciją serume praėjus 4 val. ir 20 val. po operacijos. Įvertinome netekto kraujo kiekį per 20 val. laikotarpį. Rezultatai Grupių demografiniai, intraoperaciniai duomenys, kairiojo skilvelio išstūmimo frakcija, NYHA funkcinė klasė nesiskyrė. Prieš operaciją ir praėjus 4 val. po operacijos hemoglobino, hematokrito, leukocitų, C reaktyviojo baltymo, prokalcitonino vertės grupėse buvo panašios. Hemoglobino, hematokrito vertės, leukocitų skaičius tarp grupių reikšmingai nesiskyrė ir po 20 val. bei penktą parą. Praėjus 20 val. po operacijos, prokalcitonino koncentracijos padidėjimas (> 0,5–2 ng/ml) dažniau pasitaikė II grupės ligoniams (58,3% / 33,3%). Penktą parą C reaktyviojo baltymo vertė buvo mažesnė I grupėje (70,63 ± 34,23), palyginti su II grupe (93,53 ± 45,48; p < 0,05). Pooperacinis kraujo netekimas per pirmąsias 20 val. tarp grupių reikšmingai nesiskyrė. Alogeninio kraujo transfuzijų poreikis buvo reikšmingai mažesnis I grupės ligoniams: 14,6% / 38,8% (p < 0,05). Infekcinės komplikacijos registruotos I grupės 2,4% ligonių ir II grupės 10,2% ligonių (p < 0,05) Pooperacinio hospitalizavimo trukmė 35,19% buvo trumpesnė I grupės tiriamųjų (p < 0,05). Išvada Ankstyva po širdies operacijos ištekėjusio autologinio, centrifuguoto kraujo reinfuzija nedidino kraujavimo bei sisteminio uždegiminio atsako. Autologinių eritrocitų ankstyvos reinfuzijos grupėje mažėjo alogeninio kraujo transfuzijų poreikis, infekcinių komplikacijų rizika, buvo trumpesnė pooperacinio hospitalizavimo trukmė. Pagrindiniai žodžiai: autologinis kraujas, alogeninis kraujas, dirbtinė kraujo apytaka Benefit of early reinfusion of autologous shed mediastinal blood after cardiac surgery Audronė Veikutienė1, Rimantas Benetis1, Edmundas Širvinskas2, Pranas Grybauskas3, Judita Andrejaitienė2, Vincentas Veikutis2, Jonas Šurkus41 Kaunas University of Medicine Hospital, Department of Cardiothoracic and Vascular Surgery,Eivenių str. 2, LT-50009 Kaunas, Lithuania2 Kaunas University of Medicine, Institute for Biomedical Research,Eivenių str. 2, LT-50009 Kaunas, Lithuania3 Kaunas University of Medicine, Institute of Cardiology,Eivenių str. 2, LT-50009 Kaunas, Lithuania4 Kaunas University of Medicine Hospital, Department of Nefrology,Eivenių str. 2, LT-50009 Kaunas, LithuaniaE-mail: [email protected] Background / objective Various strategies have been proposed to decrease allogeneic transfusion requirements after cardiac surgery. The aim of the study was to evaluate the efficacy of collected and reinfused autologous shed mediastinal blood on the postoperative cource. Patients and methods We investigated 90 patients who underwent cardiac surgery with cardiopulmonary bypass. The patients were divided into two groups: group I (n = 41) received the centrifuged autologous shed mediastinal blood collected from the cardiotomy reservoir following 4 hours after surgery; in group II (n = 49) all shed mediastinal blood was discarded (control group). Haemoglobin, haematocrit, C-reactive protein values, leucocyte count were compared before surgery, 4 h, 20 h after surgery and on the fifth postoperative day. We have measured serum procalcitonin concentration at 4 h and 20 h after cardiopulmonary bypass. We assessed drained blood loss within 20 postoperative hours. Results There were no significant differences in patients’ demographic, operative data, left ventricle ejection fraction, NYHA functional class between the two groups. C-reactive protein, procalcitonin concentration, haemoglobin, haematocrit values, leucocyte count did not differ between the groups before and at 4 hours after surgery. Haemoglobin, haematocrit level, leucocyte count were similar at 20 hours and on the fifth day after surgery. At 20 hours after surgery, an increase of serum procalcitonin concentration (> 0.5–2 ng/ml) was more frequent in group II (58.3% vs 33.3%). On the fifth postoperative day, the C-reactive protein value was lower in group I (70.63 ± 34.23; p < 0.05), compared to group II (93.53 ± 45.48). Postoperative blood loss did not differ between the groups. Requirement for allogeneic transfusion was significantly lower in group I (14.6% vs 38.8%; p < 0.05). Patients in group I developed less infective complications as compared with the group II (2.4% and 10.2%, respectively; p < 0.05). The length of postoperative in-hospital stay was shorter by 35.19% in group I (p < 0.05) as compared with group II. Conclusions Reinfusion of centrifuged autologous shed mediastinal blood did not increase bleeding tendency and systemic inflammatory response. Requirement for allogeneic transfusion, the risk of postoperative infection and the length of postoperative in-hospital stay was lower in autotransfused patients (group I). The estimation of serum procalcitonin concentration is a usable and rather informative test for evaluating inflammatory response activity after cardiac surgery. Key words: autologous blood, allogeneic blood, cardiopulmonary bypass

scholarly journals Assessment of the Accuracy of Procalcitonin to Diagnose Postoperative Infection after Cardiac Surgery

2007 ◽  
Vol 107 (2) ◽  
pp. 232-238 ◽  
Author(s):  
Mohamed Adel Jebali ◽  
Pierre Hausfater ◽  
Zoubeir Abbes ◽  
Zied Aouni ◽  
Bruno Riou ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Postoperative Infection ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Reactive Protein

Background Cardiopulmonary bypass induces a nonspecific inflammatory response. Procalcitonin has been advocated as a specific biomarker for infection. The authors studied the accuracy of procalcitonin to diagnose postoperative infection after cardiac surgery and compared it with those of C-reactive protein, white blood cell count, and interleukins 6 and 8. Methods The authors prospectively included 100 patients scheduled to undergo elective cardiac procedures with cardiopulmonary bypass. Blood samples were taken before surgery and each day over the 7-day postoperative period, and measurement of procalcitonin, C-reactive protein, white blood cell count, and interleukins 6 and 8 were performed. Diagnosis of infection was performed by a blinded expert panel. Data are expressed as value [95% confidence interval]. Results Infection was diagnosed in 16 patients. Procalcitonin was significantly higher in infected patients, with a peak reached on the third postoperative day. Only the areas under the receiver operating curve of procalcitonin (0.88 [0.71-0.95]) and C-reactive protein (0.72 [0.58-0.82]) were significantly different from the no-discrimination curve, and that of procalcitonin was significantly different from those of C-reactive protein, white blood cell count, and interleukins 6 and 8. A procalcitonin value greater than 1.5 ng/ml beyond the second day diagnosed postoperative infection with a sensitivity of 0.93 [0.70-0.99] and a specificity of 0.80 [0.70-0.87]. Procalcitonin was significantly higher in patients who died (27.5 [1.65-40.5] vs. 1.2 [0.7-1.5] ng/ml; P &lt; 0.001). Conclusion Procalcitonin is a valuable marker of bacterial infections after cardiac surgery.

scholarly journals Correlation Between CRP Il-6 Level, Severity and Mortality in Patients with Covid-19 Infection in Indonesia

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Inge Andriani ◽  
Arie Utariani ◽  
Elizeus Hanindito ◽  
Prananda Surya Airlangga
Keyword(s):  
P Value ◽  
Test Results ◽  
Comorbid Disease ◽  
C Reactive Protein ◽  
Exclusion Criteria ◽  
Reactive Protein ◽  
Cohort Design ◽  
Observational Cohort ◽  
R Value ◽  
Complications And Mortality

Background: IL-6 plays an important role in the occurrence of cytokine storm and is the major inducer of C-reactive protein (CRP) gene expression in the liver. This study aims to analyze CRP and IL-6 levels as markers of severity and mortality in COVID-19 patients. Methods: 50 subjects met the inclusion and exclusion criteria; the study was conducted using a retrospective observational cohort design and analyzed using Spearman-Rho and Mann Whitney test. Results: There is relationship between CRP and the severity of COVID-19 with p value < 0.001 and r value 0.604. The severity of IL-6 and COVID-19 was also associated with a p-value of 0.017 and an R-value of 0.337. CRP was also associated with mortality with a p value of 0.004, where the baseline SOFA score was p < 0.001 and the r value was 0.551. IL-6 was associated with symptom onset with a p-value of 0.027 and an R-value of 0.314. Meanwhile, CRP and IL-6 were associated with mechanical ventilation treatment with p-values ​​of 0.013 and 0.027, respectively. CRP also has a strong correlation with IL-6 levels with p value < 0.001 and r value 0.557. Conclusion: Examination of CRP and IL-6 was associated with severity, complications and mortality in COVID-19 patients, except that IL-6 was not associated with mortality because it is influenced by the patient’s comorbid disease.

scholarly journals The clinical significance of interleukin-6, C-reactive protein, and procalcitonin in the early recognition of nosocomial infections in preterm infants

2021 ◽  
Author(s):  
Xuewei Cui ◽  
Yongyan Shi ◽  
Xinyi Zhao ◽  
Xindong Xue ◽  
Jianhua Fu
Keyword(s):  
Preterm Infants ◽  
Interleukin 6 ◽  
Nosocomial Infections ◽  
Early Recognition ◽  
Sepsis Group ◽  
C Reactive Protein ◽  
Clinical Value ◽  
Roc Curve Analysis ◽  
Reactive Protein ◽  
Cutoff Values

Abstract Background: This study assessed the clinical value of interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin (PCT) for early recognition of nosocomial infections in preterm infants.Methods: 120 neonates were finally analyzed, 89 with sepsis were compared with 31 noninfected controls. IL-6, CRP and PCT were measured at certain stages. Receiver-operating characteristic (ROC) curve analysis was used to determine the best cutoff values of IL-6, CRP, and PCT for diagnosing sepsis.Results: In the sepsis group, IL-6 peaked 6 hours after the infection onset and dropped to normal 24–48 hours after the infection was controlled. The best cutoff values of IL-6, CRP, and PCT were >99.6 pg/mL, >9.27 mg/L, and >2.33 ng/mL, respectively. The areas under the ROC curves were 0.888, 0.823, and 0.953, respectively. When PCT was combined with IL-6 or IL-6 and CRP, the sensitivity and specificity were >85%.Conclusion: IL-6, CRP, and PCT are reliable indicators for early diagnosis of nosocomial infections in preterm infants. Combining PCT and IL-6, CRP with IL-6 and PCT levels could improve the accuracy of clinical diagnosis.

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