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

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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Assessment of Anti-oxidant and Anti-inflammatory Properties of Green Tea in Critically Ill Patients with Pneumonia

10.21203/rs.3.rs-21171/v1 ◽

2020 ◽

Author(s):

Zohre Labbani-Motlagh ◽

Ramin Abrishami ◽

Saeed Mohammadi Motamed ◽

Reza Shahrami

Keyword(s):

Placebo Group ◽

Critically Ill ◽

Green Tea ◽

Critically Ill Patients ◽

Small Sample Size ◽

Small Sample ◽

Apache Ii Score ◽

Controlled Clinical Trial ◽

Stimulant Effect ◽

Tea Extract

Abstract Background: Systemic inflammatory response syndrome is common in critically ill patients and negatively affects clinical outcomes. Preventing oxidative damage, may suppress this systemic response. Previous studies confirmed that polyphenols in green tea have both antioxidant and immuno-stimulant effect, so there could be a probability of green tea clinical application. Two groups of 8 patients enrolled in this randomized, controlled clinical trial. Treatment group received Green Tea Extract (GTE), and placebo group received extract's solvent for 7 days. Blood samples taken 3 times/week and oxidative, physiologic and inflammatory markers were measured. Results: Differences between the baselines for each variable were not significant. FRAP value showed slower decrease in GTE group. Thiol level increased in GTE group and decreased in Placebo group. IL-6 and APACHE II score were lower in GTE group on day7. Leucocyte count showed overall increase in GTE group and decrease in placebo group. Differences between two groups in all aforementioned variables were statistically insignificant.Conclusion: As a conclusion green tea had no significant effect on all measured variables; but in GTE group despite better oxidative status in the first 3 days, more inflammation was observed on day7. Considering small sample size further investigations are needed.

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A single-centre study of safety and efficacy of prone positioning for critically ill patients on veno-venous extracorporeal membrane oxygenation

Australian Critical Care ◽

10.1016/j.aucc.2020.10.011 ◽

2020 ◽

Author(s):

Hanna Chaplin ◽

Shay McGuinness ◽

Rachael Parke

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Critically Ill ◽

Critically Ill Patients ◽

Prone Positioning ◽

Single Centre ◽

Safety And Efficacy ◽

Centre Study ◽

Membrane Oxygenation ◽

Single Centre Study

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

Critical Care Research and Practice ◽

10.1155/2011/594645 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 16

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.

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