Abstract Objective To investigate the correlation between serum procalcitonin (PCT) level and pediatric critical illness score (PCIS) and their prognostic values in children with sepsis. Methods Sixty-one children with sepsis in the pediatric intensive care unit were enrolled. According to PCIS, these patients were divided into non-critical (n=18), critical (n=20), and extremely critical groups (n=23). Within 24 hours after admission, serum levels of PCT, C-reactive protein (CRP), and lactic acid (LA) and routine blood counts were measured. These parameters were compared between the three groups. The Pearson correlation analysis was performed to determine the correlation of PCT with PCIS and other serological parameters. Based on clinical outcomes, these patients were divided into survival (n=39) and death groups (n=22). The PCT, PCIS, and other serological parameters were compared between the two groups. Results The serum levels of PCT and CRP in the non-critical group were significantly lower than those in critical group and extremely critical groups (PPPr=-0.63, Pr=0.73, P=0.003). Compared with the death group, the survival group had significantly higher serum levels of PCT and LA (PPConclusions There is a good correlation between serum PCT level and PCIS. For children with sepsis, the lower the PCIS, the higher the serum PCT level, resulting in a poorer prognosis. A combination of serum PCT and PCIS can be used as an early prognostic indicator in children with sepsis.
QI Ying-Zheng. Prognostic values of serum procalcitonin level and pediatric critical illness score in children with sepsis[J]. CJCP, 2014, 16(2): 190-193.
QI Ying-Zheng. Prognostic values of serum procalcitonin level and pediatric critical illness score in children with sepsis[J]. CJCP, 2014, 16(2): 190-193.
Burn-Buisson C. The epidemiology of the systemic inflammatory response[J]. Intensive Care Med, 2000, 26 Suppl 1: S64-S74.
[3]
Olaciregui I, Hernandez U, Munoz JA, et al. Markers that predict serious bacterial infection in infants under 3 months of age presenting with fever of unknown origin[J]. Arch Dis Child, 2009, 94(7): 501-505.
[4]
Venkatesh B, Kennedy P, Kruger PS, et al. Changes in serum procalcitonin and C-reactive protein following antimicrobial therapy as a guide to antibiotic duration in the critically ill: a prospective evaluation[J]. Anaesth Intensive Care, 2009, 37(1): 20-26.
[5]
Simon P, Milbrandt EB, Emlet LL. Procalcitonin-guided antibiotics in severe sepsis[J]. Crit Care, 2008, 12(6): 309.
[6]
Nakamura A, Wada H, Ikejiri M, et al. Efficacy of procalcitonin in the early diagnosis of bacterial infections in a critical care unit[J]. Shock, 2009, 31(6): 586-591.
Dahaba AA, Metzler H. Procalcitonin's role in the sepsis cascade. Is procalcitonin a sepsis marker or mediator?[J]. Minerva anestesiol, 2009, 75(7-8): 447-452.
[12]
Indino P, Lemarchand P, Bady P, et al. Prospective study on procalcitonin and other systemic infection markers in patients with leukocytosis[J]. Int J Infect Dis, 2008, 12(3): 319-324.
[13]
Tang BM, Eslick GD, Craig JC, et al. Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis[J]. Lancet Infect Dis, 2007, 7(3): 210-217.
Castelli GP, Pognani C, Cita M, et al. Procalcitonin, C-reactive protein, white blood cells and SOFA score in ICU: diagnosis and monitoring of sepsis[J]. Minerva Anestesiol, 2006, 72(1-2): 69-80.
[16]
Suarez-Santamaria M, Santolaria F, Perez-Ramirez A, et al. Prognostic value of inflammatory markers (notably cytokines and procalcitonin), nutritional assessment, and organ function in patients with sepsis[J]. Eur Cytokine Netw, 2010, 21(1): 19-26.
[17]
Giamarellos-Bourboulis EJ, Tsangaris I, Karenni T, et al. Procalcitonin as an early indicator of outcome in sepsis: a prospective observation study[J]. J Hosp Infect, 2011, 77(1): 58-63.
[18]
Rey C, Los Arcos M, Concha A, et al. Procalcitonin and C-reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children[J]. Intensive Care Med, 2007, 33(3): 477-484.
[19]
Muller B, Harbarth S, Stolz D, et al. Diagnostic and prognostic accuracy of clinical and laboratory parameters in communityacquired pneumonia[J]. BMC Infect Dis, 2007, 7: 10.
[20]
Marik PE. Definition of sepsis: not quite time to dump SIRS?[J]. Crit Care Med, 2002, 30(3): 706-708.