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Acute-phase reactants after paediatric cardiac arrest. Procalcitonin as marker of immediate outcome

Marta Los Arcos1, Corsino Rey, Andrés Concha

  • 1Paediatric Intensive Care Unit, Department of Paediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain. martalosarcos@yahoo.es

BMC Pediatrics
|May 2, 2008
PubMed

Insights

Procalcitonin (PCT) levels measured within 24 hours after pediatric cardiac arrest can indicate mortality risk. Higher PCT levels in non-survivors suggest its utility as a prognostic marker in pediatric critical care.

Area of Science:

  • Pediatric Critical Care Medicine
  • Biomarkers in Critical Illness
  • Cardiorespiratory Resuscitation

Background:

  • Procalcitonin (PCT) and C-reactive protein (CRP) are established infection markers.
  • PCT levels correlate with infection severity, progression, and mortality.
  • Post-cardiac arrest syndrome involves systemic inflammation and potential endotoxin tolerance.

Purpose of the Study:

  • To investigate the time-course of PCT and CRP levels following pediatric cardiac arrest.
  • To evaluate PCT and CRP as potential markers for immediate survival after pediatric cardiac arrest.

Main Methods:

  • Retrospective observational study in a university hospital PICU over two years.
  • Eleven pediatric patients (<14 years) admitted after cardiac arrest were included.
  • PCT and CRP plasma concentrations measured at 12 and 24 hours post-admission.

Main Results:

  • PCT levels rose 12 hours post-arrest in both survivors and non-survivors.
  • Non-survivors showed a significant further increase in PCT between 12 and 24 hours (median 205.5 ng/mL vs. 22.7 ng/mL in survivors, p < 0.05).
  • CRP levels were elevated in all patients, with no significant difference between survivors and non-survivors at 12 and 24 hours.

Conclusions:

  • PCT measurement within 24 hours after pediatric cardiac arrest may serve as a mortality marker.
  • PCT kinetics, particularly the rise between 12 and 24 hours, differentiate survivors from non-survivors.
  • CRP levels did not show prognostic value in this cohort.
Abstract

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