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[Kinetics of C-reactive protein and procalcitonin after paediatric cardiac surgery]
D Crespo-Marcos1, C Rey-Galán, J López-Herce-Cid
1Hospital Universitario Fundación Alcorcón, Madrid, España. davidkrespo@yahoo.com
Insights
C-reactive protein (CRP) does not predict complications after pediatric cardiac surgery. Procalcitonin (PCT) shows correlation with clinical severity and aids in detecting post-surgical complications in these patients.
Area of Science:
- Biomarkers in Medicine
- Pediatric Cardiac Surgery
- Inflammatory Response
Background:
- Systemic inflammatory response syndrome post-cardiac surgery can mask complications.
- Accurate detection of complications is crucial for patient outcomes.
Purpose of the Study:
- To investigate the behavior of C-reactive protein (CRP) and procalcitonin (PCT) after pediatric cardiac surgery.
- To evaluate the relationship of CRP and PCT with clinical severity and their utility in identifying complications.
Main Methods:
- Prospective study of 59 children undergoing cardiac surgery with cardiopulmonary bypass.
- Measurement of CRP and PCT at baseline and 24, 48, 72 hours post-surgery.
- Analysis of CRP and PCT correlation with PRISM and TISS scores and complication incidence.
Main Results:
- Both CRP and PCT levels peaked at 24 hours post-surgery, then declined.
- CRP showed no association with severity or complications.
- PCT correlated moderately with PRISM scores and showed potential for complication detection with specific cut-off values.
Conclusions:
- CRP is not a reliable marker for severity or complications in pediatric cardiac surgery.
- PCT correlates with clinical severity and can assist in identifying post-surgical complications.
Introduction And Objectives:
The systemic inflammatory response syndrome developed after cardiac surgery impedes the detection of complications. The aim of our study was to examine the behaviour of C-reactive protein (CRP) and procalcitonin (PCT), as well as to evaluate its relationship with severity and to analyse its usefulness in the identification of complications.
Methods:
A total of 59 children who underwent cardiac surgery with cardiopulmonary bypass were prospectively studied. CRP and PCT were determined after surgery and at 24, 48 and 72 hours. The relationships between both parameters and the clinical severity were analysed (evaluated with PRISM and TISS scoring systems), as well as with the incidence of complications (infectious and haemodynamics).
Results:
Serum concentrations of CRP and PCT increased in the first 24 hours after surgery, with a gradual decrease over the following days. There was no association between CRP and severity or development of complications. A moderate correlation was observed between PCT after surgery, at 24 and 48 hours, and PRISM (r=0.548; 0.434 and 0.446) and a low correlation between PCT and TISS. When studying the identification of complications, we obtained cut-off values of PCT>0.17ng/ml (Ss 73.3%; Sp 72.2%) and PCT>1.98ng/ml (Ss 57.1%; Sp 87%) immediately and 48 hours after surgery. No differences were found in CPR and PCT levels among patients with infectious and haemodynamics complications.
Conclusions:
CPR does not correlate with the severity or the incidence of complications after paediatric cardiac surgery. PCT correlates with clinical severity and may be able to detect post-surgical complications.
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