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[Predictive value of procalcitonin in children with suspected sepsis]
Raúl Bustos B1, Oslando Padilla P2
1Unidad de Cuidado Intensivo Pediátrico, Hospital Guillermo Grant Benavente, Concepción, Chile.
Insights
Procalcitonin (PCT) effectively predicts mortality and septic shock in children with sepsis, outperforming C-reactive protein (CRP) and lactate. PCT aids in stratifying sepsis severity upon pediatric intensive care unit admission.
Area of Science:
- Pediatric critical care medicine
- Biomarker research
- Infectious diseases
Background:
- Biomarkers are crucial for diagnosing, prognosing, and stratifying pediatric sepsis.
- Evaluating procalcitonin (PCT), C-reactive protein (CRP), and lactate is essential for understanding their roles in pediatric sepsis.
Purpose of the Study:
- To analyze the predictive value of PCT, CRP, and lactate for mortality, septic shock, and patient stratification in children with suspected sepsis.
Main Methods:
- A prospective study involving 81 pediatric intensive care unit patients.
- Plasma levels of PCT, CRP, and lactate were measured at admission.
- Patients were classified based on sepsis severity: systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock.
Main Results:
- PCT concentrations significantly increased with sepsis severity (P<.001).
- PCT demonstrated strong discriminative power for predicting septic shock (AUC=0.91) and mortality (AUC=0.80).
- PCT outperformed CRP and lactate in predicting these outcomes.
Conclusions:
- Procalcitonin (PCT) is a valuable predictor of mortality and septic shock in pediatric sepsis.
- PCT aids in stratifying children based on sepsis severity upon intensive care unit admission.
- PCT offers superior predictive capabilities compared to CRP and lactate in this population.
Introduction:
The use of biomarkers could be a tool for diagnosis, prognosis and stratifying children with sepsis. Our main goal was to analyze the value of procalcitonin (PCT), C reactive protein (CRP) and lactate in predicting mortality, septic shock and the stratification in children with suspected sepsis
Patients And Method:
Prospective study in 81 patients. Plasma levels of PCT, CRP and lactate were measured at admission in the pediatric intensive care unit. Patients were categorized into systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock.
Results:
Concentrations of PCT (ng/mL) increased significantly according to the severity of sepsis: 0.36 (0-1.2) for systemic inflammatory response syndrome; 1.96 (0.4-3.5) for sepsis; 7.5 (3.9-11.1) for severe sepsis; and 58.9 (35.1-82.7) for septic shock (P<.001). Compared to CRP and lactate, the area under the ROC curve revealed a good discriminative power of PCT to predict septic shock and mortality, 0.91 (95% CI: 0.83-0.97) and 0.80 (95% CI: 0.69-0.88), respectively.
Conclusions:
In contrast to CRP and lactate, the determination of PCT in pediatric intensive care unit admission is a good predictor of mortality and septic shock and can stratify patients according to severity of sepsis.
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