scholarly journals Procalcitonin is a Better Biomarker than C-Reactive Protein in Newborns Undergoing Cardiac Surgery: The Prokineca Study

2016 ◽  
Vol 11 ◽  
pp. BMI.S40658 ◽  
Author(s):  
Sara Bobillo Pérez ◽  
Javier Rodríguez-Fanjul ◽  
Iolanda Jordan García ◽  
Julio Moreno Hernando ◽  
Martín Iriondo Sanz
Keyword(s):  
Cardiopulmonary Bypass ◽  
Neonatal Intensive Care ◽  
Area Under The Curve ◽  
C Reactive Protein ◽  
Sepsis Diagnosis ◽  
Reactive Protein ◽  
Optimal Area ◽  
A Prospective Study ◽  
Kinetics Of ◽  
Better Than

Objectives To assess the kinetics of procalcitonin (PCT) and C-reactive protein (CRP) in newborns after cardiothoracic surgery (CS), with and without cardiopulmonary bypass, and to assess whether PCT was better than CRP in identifying sepsis in the first 72 hours after CS. Patients and Methods This is a prospective study of newborns admitted to the neonatal intensive care unit after CS. Interventions PCT and CRP were sequentially drawn 2 hours before surgery and at 0, 12, 24, 48, and 72 hours after surgery. Results A total of 65 patients were recruited, of which 14 were excluded because of complications. We compared the kinetics of PCT and CRP after CS in bypass and non-bypass groups without sepsis; there were no differences in the PCT values at any time (24 hours, P = 0.564; 48 hours, P = 0.117; 72 hours, P = 0.076). Thirty-five patients needed bypass, of whom four were septic (11.4%). Significant differences were detected in the PCT values on comparing the septic group to the nonseptic group at 48 hours after cardiopulmonary bypass ( P= 0.018). No differences were detected in the CRP values in these groups. A suitable cutoff for sepsis diagnosis at 48 hours following bypass would be 5 ng/mL, with optimal area under the curve of 0.867 (confidence interval 0.709–0.958), P< 0.0001, and sensitivity and specificity of 87.5% (29.6–99.7) and 72.6% (53.5–86.4), respectively. Conclusions This is a preliminary study but PCT seems to be a good biomarker in newborns after CS. Values over 5 ng/mL at 48 hours after CS should alert physicians to the high risk of sepsis in these patients.

Post-operative kinetics of C-reactive protein to distinguish between bacterial infection and systemic inflammation in infants after cardiopulmonary bypass surgery: the early and the late period

2021 ◽  
pp. 1-8
Author(s):  
Hanna Renk ◽  
David Grosse ◽  
Sarah Schober ◽  
Christian Schlensak ◽  
Michael Hofbeck ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Bacterial Infection ◽  
Congenital Heart ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Post Operative Period ◽  
Kinetics Of

Abstract Objectives: Differentiation between post-operative inflammation and bacterial infection remains an important issue in infants following congenital heart surgery. We primarily assessed kinetics and predictive value of C-reactive protein for bacterial infection in the early (days 0–4) and late (days 5–28) period after cardiopulmonary bypass surgery. Secondary objectives were frequency, type, and timing of post-operative infection related to the risk adjustment for congenital heart surgery score. Methods: This 3-year single-centre retrospective cohort study in a paediatric cardiac ICU analysed 191 infants accounting for 235 episodes of CPBP surgery. Primary outcome was kinetics of CRP in the first 28 days after CPBP surgery in infected and non-infected patients. Results: We observed 22 infectious episodes in the early and 34 in the late post-operative period. CRP kinetics in the early post-operative period did not accurately differentiate between infected and non-infected patients. In the late post-operative period, infected infants displayed significantly higher CRP values with a median of 7.91 (1.64–22.02) and 6.92 mg/dl (1.92–19.65) on days 2 and 3 compared to 4.02 (1.99–15.9) and 3.72 mg/dl (1.08–9.72) in the non-infection group. Combining CRP on days 2 and 3 after suspicion of infection revealed a cut-off of 9.47 mg/L with an acceptable predictive accuracy of 76%. Conclusions: In neonates and infants, CRP kinetics is not useful to predict infection in the first 72 hours after CPBP surgery due to the inflammatory response. However, in the late post-operative period, CRP is a valuable adjunctive diagnostic test in conjunction with clinical presentation and microbiological diagnostics.

scholarly journals The Mortality in Emergency Department Sepsis Score as a Predictor of 1-Month Mortality among Adult Patients with Sepsis: Weighing the Evidence

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Bayushi Eka Putra ◽  
Ling Tiah
Keyword(s):  
Emergency Department ◽  
Outcome Measure ◽  
Selection Process ◽  
Area Under The Curve ◽  
C Reactive Protein ◽  
Consensus Process ◽  
Suspected Sepsis ◽  
Reactive Protein ◽  
Sepsis Score ◽  
Better Than

Objective. To evaluate the performance of Mortality in Emergency Department Sepsis (MEDS) score in comparison to biomarkers as a predictor of mortality in adult emergency department (ED) patients with sepsis. Methods. A literature search was performed using PubMed, ScienceDirect, SpringerLink, and Ovid databases. Studies were appraised by using the C2010 Consensus Process for Levels of Evidence for prognostic studies. The respective values for area under the curve (AUC) were obtained from the selected articles. Results. Four relevant articles met the selection process. Three studies defined the 1-month mortality as death occurring within 28 days of ED presentation, while the remaining one subcategorised the outcome measure as (5-day) early and (6- to 30-day) late mortality. In all four studies, the MEDS score performed better than the respective comparators (C-reactive protein, lactate, procalcitonin, and interleukin-6) in predicting mortality with an AUC ranging from 0.78 to 0.89 across the studies. Conclusion. The MEDS score has a better prognostic value than the respective comparators in predicting 1-month mortality in adult ED patients with suspected sepsis.

scholarly journals Qualitative C-reactive protein as a marker of neonatal sepsis in a tertiary neonatal unit in Sudan

2013 ◽  
Vol 1 (2) ◽  
pp. 21
Author(s):  
Abdelmoneim E. Kheir ◽  
Ghada A. Jobara ◽  
Kamal M. Elhag ◽  
Mohamed Z. Karar
Keyword(s):  
Risk Factors ◽  
Blood Culture ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
University Hospital ◽  
C Reactive Protein ◽  
Chi Square ◽  
Reactive Protein ◽  
Chi Square Test ◽  
A Prospective Study

Sepsis is one of the most common causes of morbidity and mortality in newborns. Diagnosis of neonatal sepsis may be difficult because clinical presentations are often non-specific. The aim of this study was to evaluate the role of qualitative C-reactive protein in the diagnosis of neonatal sepsis, and examine the correlation between C-reactive protein, blood culture and risk factors for sepsis. This was a prospective study, conducted in the Neonatal Intensive Care Unit at Soba University Hospital, Sudan. A total of seventy babies with a clinical diagnosis of sepsis were included. Chi square test was used to determine the association between C-reactive protein and risk factors for sepsis and also the association between C-reactive protein and blood culture. Blood culture was positive in 41.4% of babies, and C-reactive protein was positive in 58% of babies with positive blood culture. There was significant association between C-reactive protein results and blood culture (P=0.00). In conclusion, we can assume that Creactive protein is a reliable diagnostic marker of neonatal sepsis, especially in developing communities with poor resources.

scholarly journals COMPARISON OF PRESEPSIN, PROCALCITONIN, INTERLEUKIN-8 AND C-REACTIVE PROTEIN IN PREDICTING BACTERAEMIA IN FEBRILE NEUTROPENIC ADULT PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES

2019 ◽  
Vol 11 (1) ◽  
pp. e2019047 ◽  
Author(s):  
Irena Kostic ◽  
Carmela Gurrieri ◽  
Elisa Piva ◽  
Gianpietro Semenzato ◽  
Mario Plebani ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Bacterial Infections ◽  
Area Under The Curve ◽  
Interleukin 8 ◽  
Adult Patients ◽  
Haematological Malignancies ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Life Threatening ◽  
Better Than

Bacterial infections represent life-threatening complications in patients with febrile neutropenia (FN). Biomarkers of infections may help to differentiate bacteraemia from non-bacteraemia FN. We aimed to evaluate the utility of procalcitonin (PCT), presepsin (PS), C-reactive protein (CRP) and interleukin-8 (IL-8) as biomarkers of bacteraemia in adult FN patients with haematological malignancies. Thirty-six FN episodes experienced by 28 oncohematological patients were considered. 11 out of 36 episodes were classified as bacteraemia. PCT was the best biomarker to predict bacteraemia with area under the curve (AUC) ROC of 0,9; while the most sensitive was IL-8 (90,9%) with AUC ROC of 0,88. All patients with PCT concentrations above 1,6 μg/l had bacteraemia. Patients with IL-8 concentrations > 170 pg/ml or PS concentrations superior then 410 pg/ml had 40 times and 24 times higher risk for bacteraemia, respectively. PCT remains better than IL-8 and PS in predicting bacteraemia in adult hematological patients with FN.

Diagnosing infection after infant open heart surgery: role of procalcitonin

2019 ◽  
Vol 27 (8) ◽  
pp. 641-645
Author(s):  
Dicky Fakhri ◽  
Eva Miranda Marwali ◽  
Novik Budiwardhana ◽  
Poppy Surwianti Roebiono ◽  
Anna Ulfah Rahajoe ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Systemic Inflammatory Response Syndrome ◽  
Bacterial Infection ◽  
Leukocyte Count ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Leukocyte Counts ◽  
Post Cardiopulmonary Bypass ◽  
Better Than

Background Diagnosing infection in infants after cardiac surgery with cardiopulmonary bypass remains challenging. We aimed to determine whether procalcitonin discriminates post-cardiopulmonary bypass systemic inflammatory response syndrome from bacterial infection in infants better than C-reactive protein and leukocyte count. Method One hundred and eight infants underwent cardiac surgery with cardiopulmonary bypass. Leukocyte count, C-reactive protein, and procalcitonin were measured on arrival in the intensive care unit as baseline, and repeated on postoperative day 3. Bacterial infection was defined as proven infection with a positive blood or sputum culture. Results Twenty-four infants had proven bacterial infection. Baseline leukocyte counts and C-reactive protein levels did not differ significantly between the 2 groups. On postoperative day 3, C-reactive protein (62 vs. 38.5 mg·L−1, p = 0.01) and procalcitonin levels (6.58 vs. 0.41 ng·mL−1, p < 0.01) were higher in patients with bacterial infection. Leukocyte counts did not differ significantly between the two groups ( p = 0.94). The area under the receiver operating curve for leukocyte count, C-reactive protein, and procalcitonin was 0.49 ( p = 0.94), 0.67 ( p = 0.01), and 0.87 ( p < 0.0010), respectively. The optimal cutoff value of procalcitonin was 2.5 ng·mL−1 (sensitivity 75%, specificity 88%). Conclusion In infants undergoing cardiac surgery with cardiopulmonary bypass, procalcitonin discriminates bacterial infection from post-cardiopulmonary bypass systemic inflammatory response syndrome better than C-reactive protein and leukocyte count.

scholarly journals Diagnostic Value of C-Reactive Protein in Discrimination between Uncomplicated and Complicated Parapneumonic Effusion

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 829
Author(s):  
Yana Kogan ◽  
Edmond Sabo ◽  
Majed Odeh
Keyword(s):  
Area Under The Curve ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Significant Difference ◽  
Study Population ◽  
Complicated Parapneumonic Effusion

Objectives: The role of serum C-reactive protein (CRPs) and pleural fluid CRP (CRPpf) in discriminating uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE) is yet to be validated since most of the previous studies were on small cohorts and with variable results. The role of CRPs and CRPpf gradient (CRPg) and of their ratio (CRPr) in this discrimination has not been previously reported. The study aims to assess the diagnostic efficacy of CRPs, CRPpf, CRPr, and CRPg in discriminating UCPPE from CPPE in a relatively large cohort. Methods: The study population included 146 patients with PPE, 86 with UCPPE and 60 with CPPE. Levels of CRPs and CRPpf were measured, and the CRPg and CRPr were calculated. The values are presented as mean ± SD. Results: Mean levels of CRPs, CRPpf, CRPg, and CRPr of the UCPPE group were 145.3 ± 67.6 mg/L, 58.5 ± 38.5 mg/L, 86.8 ± 37.3 mg/L, and 0.39 ± 0.11, respectively, and for the CPPE group were 302.2 ± 75.6 mg/L, 112 ± 65 mg/L, 188.3 ± 62.3 mg/L, and 0.36 ± 0.19, respectively. Levels of CRPs, CRPpf, and CRPg were significantly higher in the CPPE than in the UCPPE group (p < 0.0001). No significant difference was found between the two groups for levels of CRPr (p = 0.26). The best cut-off value calculated by the receiver operating characteristic (ROC) analysis for discriminating UCPPE from CPPE was for CRPs, 211.5 mg/L with area under the curve (AUC) = 94% and p < 0.0001, for CRPpf, 90.5 mg/L with AUC = 76.3% and p < 0.0001, and for CRPg, 142 mg/L with AUC = 91% and p < 0.0001. Conclusions: CRPs, CRPpf, and CRPg are strong markers for discrimination between UCPPE and CPPE, while CRPr has no role in this discrimination.

scholarly journals Effect of cardiopulmonary bypass on serum procalcitonin and C-reactive protein concentrations

1999 ◽  
Vol 83 (4) ◽  
pp. 602-607 ◽  
Author(s):  
A Aouifi ◽  
V Piriou ◽  
P Blanc ◽  
H Bouvier ◽  
O Bastien ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals C-Reactive Protein and Cardiopulmonary Bypass in Infants under 5 Kilograms

1991 ◽  
Vol 28 (1) ◽  
pp. 109-110 ◽  
Author(s):  
I. M. Mitchell ◽  
J. C. S. Pollock ◽  
M. P. G. Jamieson ◽  
S. F. O. Donaghey ◽  
R. D. Paton ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
C Reactive Protein ◽  
Reactive Protein

The prognostic efficacy of beta2-microglobulin in acute pulmonary embolism

2017 ◽  
Vol 16 (2) ◽  
pp. 52-59
Author(s):  
Sotirios Kakavas ◽  
◽  
Aggeliki Papanikolaou ◽  
Evangelos Balis ◽  
Evgenios Metaxas ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Increased Risk ◽  
Preliminary Study ◽  
Wbc Count ◽  
A Prospective Study ◽  
Acute Pe

Our aim was to prospectively assess the prognostic value of beta2- microglobulin (b2-M) in patients with acute pulmonary embolism (PE). We conducted a prospective study of 109 patients admitted in a pulmonary clinic due to acute PE. A panel of inflammatory markers including b2-M white blood cell (WBC) count and C-reactive protein (CRP) was determined for each patient. In this preliminary study, baseline b2-M levels significantly correlated with the impairment of oxygenation and with all the parameters that are used for the early risk stratification of patients. In multivariate analysis, patients’ age and baseline b2-M levels were significantly associated with an increased risk of death. These findings require further prospective validation.

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