scholarly journals In Critically Ill Patients, Serum Procalcitonin Is More Useful in Differentiating between Sepsis and SIRS than CRP, Il-6, or LBP

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Iwan A. Meynaar ◽  
Wouter Droog ◽  
Manou Batstra ◽  
Rolf Vreede ◽  
Paul Herbrink
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
C Reactive Protein ◽  
Lipopolysaccharide Binding Protein ◽  
Single Centre ◽  
Reactive Protein ◽  
Icu Discharge ◽  
Lipopolysaccharide Binding

We studied the usefulness of serum procalcitonin (PCT), interleukin-6 (IL-6), lipopolysaccharide binding protein (LBP) levels and C-reactive protein (CRP) levels, in differentiating between systemic inflammatory response syndrome (SIRS) and sepsis in critically ill patients.Methods. In this single centre prospective observational study we included all consecutive patients admitted with SIRS or sepsis to the ICU. Blood samples for measuring CRP, PCT, IL-6 and LBP were taken every day until ICU discharge.Results. A total of 76 patients were included, 32 with sepsis and 44 with SIRS. Patients with sepsis were sicker on admission and had a higher mortality. CRP, PCT, IL-6 and LBP levels were significantly higher in patients with sepsis as compared to SIRS. With PCT levels in the first 24 hours after ICU admission <2 ng/mL, ssepsis was virtually excluded (negative predictive value 97%). With PCT >10 ng/mL, sepsis with bacterial infection was very likely (positive predictive value 88%). PCT was best at discriminating between SIRS and sepsis with the highest area under the ROC curve (0.95, 95% CI 0.90–0.99).Discussion. This study showed that PCT is more useful than LBP, CRP and IL-6 in differentiating sepsis from SIRS.

scholarly journals Prognostic Value And Daily Trend Of Interleukin-6, Neutrophil CD64 Expression, C-Reactive Protein And Lipopolysaccharide-Binding Protein In Critically Ill Patients: Reliable Predictors Of Outcome Or Not?

2015 ◽  
Vol 34 (4) ◽  
pp. 431-439 ◽  
Author(s):  
Dragan Djordjevic ◽  
Janko Pejovic ◽  
Maja Surbatovic ◽  
Jasna Jevdjic ◽  
Sonja Radakovic ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Interleukin 6 ◽  
Prognostic Value ◽  
C Reactive Protein ◽  
Lipopolysaccharide Binding Protein ◽  
Cd64 Expression ◽  
Reactive Protein ◽  
Lipopolysaccharide Binding

SummaryBackground:Severe sepsis and/or trauma complicated by multiple organ dysfunction syndrome are the leading causes of death in critically ill patients. The aim of this prospective single-centre study was to assess the prognostic value and daily trend of interleukin-6 (IL-6), neutrophil CD64 expression, C-reactive protein (CRP) and lipopolysaccharide-binding protein (LBP) regarding outcome in critically ill patients with severe trauma and/or severe sepsis. Outcome measure was hospital mortality.Methods:One hundred and two critically ill patients admitted to the intensive care unit of a tertiary university hospital were enrolled in this prospective study. Blood samples were collected on admission (day 1), days 2 and 3.Results:CD64 index was 1.6-fold higher on day 1 and 1.78-fold higher on day 2 in non-survivors (p<0.05). The area under the curve (AUC) for the CD64 index on day 1 for outcome was 0.727. At a cut-off level of 2.80 sensitivity was 75% and specificity was 65%. Patients with CD64 index level on day 1 higher than 2.80 had 2.4-fold higher probability of dying. Odds ratio is 2.40; 95% CI 0.60–9.67.Conclusions:CD64 index on day 1 is a fairly good predictor of outcome. AUCs for IL-6, CRP and LBP were < 0.55, suggesting these biomarkers failed to predict outcome.

scholarly journals Procalcitonin Clearance for Early Prediction of Survival in Critically Ill Patients with Severe Sepsis

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Mohd Basri Mat Nor ◽  
Azrina Md Ralib
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Small Sample Size ◽  
Small Sample ◽  
Sepsis Group ◽  
Single Centre ◽  
Dynamic Changes ◽  
Prediction Of Survival ◽  
Single Centre Study

Introduction. Serum procalcitonin (PCT) diagnosed sepsis in critically ill patients; however, its prediction for survival is not well established. We evaluated the prognostic value of dynamic changes of PCT in sepsis patients.Methods. A prospective observational study was conducted in adult ICU. Patients with systemic inflammatory response syndrome (SIRS) were recruited. Daily PCT were measured for 3 days. 48 h PCT clearance (PCTc-48) was defined as percentage of baseline PCT minus 48 h PCT over baseline PCT.Results. 95 SIRS patients were enrolled (67 sepsis and 28 noninfectious SIRS). 40% patients in the sepsis group died in hospital. Day 1-PCT was associated with diagnosis of sepsis (AUC 0.65 (95% CI, 0.55 to 0.76)) but was not predictive of mortality. In sepsis patients, PCTc-48 was associated with prediction of survival (AUC 0.69 (95% CI, 0.53 to 0.84)). Patients with PCTc-48 > 30% were independently associated with survival (HR 2.90 (95% CI 1.22 to 6.90)).Conclusions. PCTc-48 is associated with prediction of survival in critically ill patients with sepsis. This could assist clinicians in risk stratification; however, the small sample size, and a single-centre study, may limit the generalisability of the finding. This would benefit from replication in future multicentre study.

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