THE ROLE OF PROCALCITONIN AND BLOOD LACTIC ACID VALUES IN PROGNOSIS OF SEPSIS AND SEPTIC SHOCK IN POLYTRAUMA PATIENTS

Recently, the role of biomarkers to assist in the diagnosis and management of infections has been extensively explored. Based on the studies, Procalcitonin and Blood Lactic Acid can provide supportive data to clinical assessment in Polytrauma induced infectious pathology prevention, early evaluation, management of complications and predicting outcomes. We studied the cases of 21 patients who developed Polytrauma induced Sepsis/Septic shock during different stages of hospitalization. We intended to study the dynamic level changes of Procalcitonin and Blood Lactic Acid in terms of Sepsis/Septic shock - induced by different types of trauma, in survived patients. At the initial stage Blood Lactate level in polytrauma patients was high, which was dynamically normalized after starting optimization of ventilation/oxygen therapy. It was totally different in case of Biomarker Procalcitonin. So we monitored the dynamic changes of it and made the correlation between the other factors/indicators. The data was registered during the first 45 days after the admission in the ICU (intensive care unit), as all the patients who survived during this period of time had good outcome. In order to see the dynamic changes, the levels of biomarkers were measured in every 5 days and were studied using Pearson correlation scheme. The study revealed that normalization of Blood Lactic Acid is in positive correlation with reconvalescence. Procalcitonin is an indicator of illness progression severity. It has strong positive correlation with White Blood Cells (WBC) and C-reactive protein (CRP) and negative correlation with Lymphocytes (LYM). In cases of Polytrauma induced sepsis or septic shock, the level started to increase within first 72 hours after traumatic injury, pick concentration was achieved within first 25 days high from the beginning and dynamically increases within first 25 days, the tendency of gradual decrease was seen after 30 days. C - reactive protein as a nonspecific indicator of severity in pathology progression, was manifested with high levels first, followed by the procalcitonin level changes. The systematic inflammation factors, like the number of Leukocytes and Lymphocytes, concentration of C-reactive protein are in correlation with procalcitonin and can play a significant role in early evaluation and management of polytrauma induced Sepsis and Septic Shock.