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Interleukin-6 and procalcitonin in children with sepsis and septic shock
José R Fioretto1, Joelma G Martin, Cilmery S Kurokawa
1Pediatric Intensive Care Unit, Pediatrics Department, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil. jrf@fmb.unesp.br
Insights
Procalcitonin (PCT) and interleukin-6 (IL-6) can help identify pediatric sepsis and septic shock early. These biomarkers are valuable at admission and correlate with disease severity in children.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Biomarker research
Background:
- Early diagnosis of sepsis in children is crucial for effective treatment.
- Interleukin-6 (IL-6) and procalcitonin (PCT) are inflammatory markers with potential diagnostic value.
Purpose of the Study:
- To evaluate the utility of IL-6 and PCT in differentiating pediatric sepsis.
- To assess the correlation of these biomarkers with disease severity.
Main Methods:
- Prospective enrollment of 90 children (28 days to 14 years) with sepsis or septic shock.
- Measurement of IL-6 and PCT at admission (T0) and 12 hours later (T12h).
- Categorization of PCT levels to define sepsis likelihood and severity.
Main Results:
- Higher PCT levels were observed in the septic shock group compared to the sepsis group at both T0 and T12h (p<0.05).
- IL-6 levels were significantly higher in the septic shock group at T0 (p=0.001).
- IL-6 positively correlated with the Pediatric Risk of Mortality (PRISM) score in septic shock patients at admission (p=0.001).
Conclusions:
- PCT and IL-6 are valuable for the early assessment of pediatric sepsis.
- These biomarkers demonstrate diagnostic utility upon patient admission.
- Biomarker levels are associated with the severity of pediatric septic conditions.
Objectives:
To examine the behavior of interleukin-6 (IL-6) and procalcitonin (PCT) and verify whether they can be used to differentiate children with septic conditions.
Methods:
Septic children aged between 28 days and 14 years, prospectively enrolled from 01/2004 to 12/2005, were divided into sepsis (SG; n=47) and septic shock (SSG; n=43) groups. IL-6 and PCT were measured at admission (T0) and 12h later (T12h). PCT results were classed as: 0.5 ng/mL=sepsis unlikely; > or =0.5 to <2=sepsis possible; > or =2 to <10=systemic inflammation; > or =10=septic shock.
Results:
Ninety children were included. At T0, there was a higher frequency of SSG with higher PCT compared with SG [SSG: 30 (69.7%)>SG: 14 (29.8%); p<0.05]. Similar results were observed at T12h. PRISM was significantly higher for SSG patients with higher PCT than SG patients. At T0, IL-6 levels were higher in SSG [SSG: 213.10 (10.85-396.70)>SG: 63.21 (0.86-409.82); p=0.001], but not statistically different at T12h. IL-6 levels positively correlated with PRISM score in SSG patients at admission (p=0.001; r=0.86).
Conclusion:
PCT and IL-6 appear to be helpful in early assessment of pediatric sepsis, are of diagnostic value at admission, and are related to disease severity.
