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Updated: Feb 12, 2026

How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children

How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children

Published on: August 19, 2020

小児集中治療におけるプロカルシトニン動態：持続的腎代替療法の種類と用量の影響

Arife Ufacık Yöndem¹, Servet Yüce², Emrullah Aygüler³

¹Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Pediatric nephrology (Berlin, Germany)

|February 11, 2026

要旨

Background:

Acute kidney injury (AKI) is common in critically ill children, frequently necessitating continuous kidney replacement therapy (CKRT). Procalcitonin (PCT) is widely used as an infection biomarker, yet its interpretation during CKRT remains unclear. Adult data regarding extracorporeal clearance of PCT are inconsistent, while pediatric evidence is limited.

Methods:

In this prospective observational study (May 2021-October 2023), 40 critically ill children receiving CKRT in a tertiary PICU were enrolled. Serum PCT was measured at CKRT initiation (T0), 12 h (T12), and 24 h (T24). CKRT modalities (CVVH, CVVHD, CVVHDF), effluent doses, and membrane types (PS, PAES, AN69-ST) were recorded. PCT kinetics were analyzed using non-parametric tests, with correlation assessed by Spearman's rank.

Results:

Median baseline PCT was 3.6 ng/mL (IQR 0.5-27.2), rising to 7.4 (0.6-29.5) at T12 and stabilizing at 7.7 (0.6-30.5) at T24. Differences across time points were not statistically significant (p = 0.68). PCT trajectories were unaffected by CKRT modality, effluent dose, or membrane type, and no correlation was found between effluent dose and PCT changes. Stratification by high versus low effluent dosing revealed no significant differences. CKRT-related complications occurred in 17.5%, mainly filter clotting, without influencing PCT. PICU mortality was 35%, reflecting illness severity rather than CKRT.

Conclusions:

In pediatric CKRT, short-term PCT dynamics are driven by the underlying septic or inflammatory process rather than CKRT parameters. PCT typically peaks within 12 h of CKRT initiation and then stabilizes, supporting its reliability for infection monitoring and antibiotic stewardship during early CKRT. Larger studies are warranted to define long-term PCT behavior and prognostic utility.

キーワード:

急性腎障害持続的腎代替療法重症小児小児集中治療プロカルシトニン敗血症

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