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Kinetics of Procalcitonin in Pediatric Patients on Extracorporeal Membrane Oxygenation

Sara Bobillo1, Javier Rodríguez-Fanjul2, Anna Solé1

  • 1Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu and University of Barcelona, Barcelona, Spain.

Biomarker Insights
|January 19, 2018
PubMed

Insights

Procalcitonin (PCT) levels before extracorporeal membrane oxygenation (ECMO) can predict multiple organ dysfunction syndrome in pediatric patients. PCT kinetics, unaffected by ECMO, may serve as a valuable biomarker for patient evolution.

Area of Science:

  • Pediatric critical care medicine
  • Biomarker research
  • Extracorporeal membrane oxygenation

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a life-support measure for critically ill pediatric patients.
  • Monitoring inflammatory markers like procalcitonin (PCT) and C-reactive protein (CRP) is crucial during ECMO.
  • Understanding the dynamic changes of these markers is essential for predicting patient outcomes.

Purpose of the Study:

  • To evaluate the kinetic patterns of PCT and CRP in pediatric patients undergoing ECMO.
  • To determine the association between PCT and CRP levels and clinical outcomes, including morbidity and mortality.
  • To identify potential predictive values of PCT and CRP for complications during ECMO.

Main Methods:

  • A prospective observational study was conducted on pediatric patients requiring ECMO.
  • PCT and CRP levels were measured serially before ECMO initiation (P0) and up to 72 hours post-ECMO.
  • Patients were stratified into cohorts based on initial PCT levels (P0 PCT >10 ng/mL).

Main Results:

  • Forty pediatric patients were included in the study.
  • The initial PCT (P0) cutoff value of 2.55 ng/mL demonstrated high sensitivity (83%) and specificity (100%) for predicting multiple organ dysfunction syndrome.
  • Neither PCT nor CRP levels effectively predicted the risk of neurologic sequelae or mortality.

Conclusions:

  • Procalcitonin levels appear to be a reliable indicator of patient status, as they are not significantly altered by ECMO support.
  • PCT shows potential as a valuable biomarker for monitoring the clinical course and evolution of pediatric patients on ECMO.
  • Further research may explore PCT's role in guiding therapeutic interventions in this patient population.
Abstract

Keywords:
C-reactive proteinECMOinfectionmultiple organ dysfunction syndromeoutcomeprocalcitonin

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