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Published on: June 16, 2023
Use of procalcitonin in therapeutic decisions in the pediatric intensive care unit
Pierre Tissières1, Elisabeth Esteban Torné2, Johannes Hübner3
1IHU-PROMETHEUS Comprehensive Sepsis Center, Pediatric Intensive Care, Neonatal Medicine and Pediatric Emergency Department, AP-HP Paris Saclay University, Bicêtre Hospital, 78, Rue du General Leclerc, 94275, Le Kremlin-Bicêtre, France. pierre.tissieres@aphp.fr.
Insights
This guidance helps clinicians interpret procalcitonin (PCT) levels in critically ill children with suspected bacterial infections. It clarifies PCT
Area of Science:
- Pediatric critical care medicine
- Clinical biochemistry
- Infectious diseases
Background:
- Procalcitonin (PCT) is a biomarker used for bacterial infections and sepsis in children.
- Interpreting PCT in critically ill children is complex due to varied conditions affecting PCT levels.
- A need exists for clear guidance on PCT use in pediatric intensive care units (PICUs).
Purpose of the Study:
- To provide a comprehensive guidance for interpreting procalcitonin (PCT) in critically ill children.
- To support clinicians in diagnosing sepsis and guiding antibiotic therapy using PCT.
- To analyze existing literature on PCT interpretation in diverse pediatric critical care scenarios.
Main Methods:
- Comprehensive literature analysis of procalcitonin (PCT) in critically ill children.
- Review of clinical context, timing of measurement, and PCT values in sepsis diagnosis.
- Evaluation of PCT's role in guiding antibiotic therapy in pediatric intensive care.
Main Results:
- Procalcitonin (PCT) interpretation requires careful consideration of the clinical context and timing.
- Evidence supports PCT's utility in diagnosing sepsis and informing antibiotic decisions in critically ill children.
- Specific clinical conditions can influence PCT levels, necessitating nuanced interpretation.
Conclusions:
- This guidance aids clinicians in the effective use of procalcitonin (PCT) for critically ill children.
- Accurate PCT interpretation improves sepsis diagnosis and optimizes antibiotic stewardship in PICUs.
- Understanding factors influencing PCT is crucial for its reliable application in pediatric critical care.
Abstract:
Procalcitonin (PCT) is frequently used by clinicians in children with suspected bacterial infections and sepsis. However interpretation in the critically ill child may be challenging due to the complexity of underlying conditions and its impact on PCT values. Herein, we propose a guidance for the use of procalcitonin in critically ill children, supported by a comprehensive analysis of the literature, to help the clinician for interpreting PCT in the various clinical conditions encountered in pediatric intensive care units. We describe the importance of the clinical context, timing of measurement and evidence on PCT values in diagnosing sepsis and to guide antibiotic therapy in critically ill children.
