Details

Autor(en) / Beteiligte

• Claeys, Roxane
• Vinken, Stephanie
• Spapen, Herbert
• ver Elst, Kristien
• Decochez, Katelyn
• Huyghens, Luc
• Gorus, Frans K

Titel

Plasma procalcitonin and C-reactive protein in acute septic shock: Clinical and biological correlates

Ist Teil von

• Critical care medicine, 2002-04, Vol.30 (4), p.757-762

Ort / Verlag

Hagerstown, MD: by the Society of Critical Care Medicine and Lippincott Williams & Wilkins

Erscheinungsjahr

2002

Quelle

MEDLINE

Beschreibungen/Notizen

• OBJECTIVE To determine the relationship between plasma procalcitonin (PCT) levels, C-reactive protein (CRP), white blood cell count (WBC), ionized calcium (Ca), and patient outcome; and to compare the diagnostic and prognostic information provided by PCT and by CRP. DESIGN Prospective, observational study. SETTING Intensive care unit. PATIENTS Fifty-three patients with septic shock, consecutively diagnosed according to consensus guidelines. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Blood was sampled at diagnosis and 24 and 48 hrs later and in a subgroup (n = 23) after 120 hrs. PCT was measured with LUMItest and CRP with Vitros slides. Ca was calculated according to McLean-Hastings from calcium and protein levels on Vitros. In all 53 patients, PCT and CRP were elevated (>0.5 ng/mL and >10 mg/L, respectively) within 24 hrs after diagnosis. Nonsurvivors (n = 25) were older (p < .001) and had higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores (p = .02) at diagnosis but did not differ in sepsis etiology, medical history, sex ratio, levels of PCT, CRP, and Ca, or WBC count at any time point. Using logistic regression, initial PCT levels were correlated with CRP values (p = .001) and APACHE II score (p < .05), but not with age, gender, Ca levels, survival, or type of pathogen. Within 48 hrs, however, PCT levels decreased more frequently from baseline in survivors than in nonsurvivors (80% vs. 41%, p < .05). Likewise, CRP levels decreased more often in survivors (100% vs. 64%, p < .05) but only at 120 hrs. CONCLUSIONS PCT levels were correlated with the severity of disease at onset (APACHE II) and inflammation (CRP) but not with Ca levels. Inaugural PCT or CRP levels per se poorly predicted outcome but decreasing levels were associated with a higher probability of survival. In this respect, PCT was found to be an earlier marker than CRP.