contadores web
Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Scientific and technological research article

Vol. 20 No. 1 (2018)

Analysis of the association between Procalcitonin and mortality by sepsis in children under 18 years of age in an intensive care unit in Pasto, Colombia between 2012 and 2014

DOI
https://doi.org/10.22267/rus.182001.110
Submitted
July 7, 2017
Published
2018-01-01

Abstract

Introduction: Procalcitonin increases early in patients with sepsis; however, it is necessary to deepen the relationship between their levels and the multi-organ commitment, as well as their outcomes such as death. Objective: To determine whether there is an association between the values of Procalcitonin and death in children with sepsis entering the pediatric intensive care unit (PICU). Materials and methods: A cross-sectional study was made with patients under 18 years of age with sepsis, who entered the PICU of Los Angeles children's Hospital in Pasto, Colombia during 2012 and 2014. The relationship between the risk of death and the levels of Procalcitonin controlled by clinical and demographic covariates was analyzed. Results: Data from 325 patients with sepsis was analyzed. The disease showed a prevalence of 27.3%, from which 23.7% (77) died. The median age was 22 months, interquartile-RI range (6-84). The median Procalcitonin was 10 ng/mL, RI (2.95-38). Children with values > 10ng/mL have an increase in the risk of death from 2 to 6 times more, compared to those who presented lower values. Conclusion: Procalcitonin can be used as an indicator and predictor of the risk of death in children under 18 with sepsis.

References

  1. Organización Mundial de la Salud. Reducción de la mortalidad en la niñez [Internet]. Ginebra: OMS; 2016. [citado el 6 de febrero de 2015]. Disponible en: http://www.who.int/mediacentre/factsheets/fs178/es
  2. Programa de las Naciones Unidas para el Desarrollo. Objetivos de Desarrollo del Milenio: Informe 2015 [Internet]. Colombia: PNUD; 2015. [citado el 14 de mayo de 2016]. Disponible en: http://www.co.undp.org/content/colombia/es/home/presscenter/articles/2015/09/28/-c-mo-le-fue-a-colombia-con-los-odm-.html
  3. Jensen JU, Heslet L, Jensen TH, Espersen K, Steffensen P, Tvede M. Procalcitonin increase in early identification of critically ill patients at high risk of mortality. Crit Care Med. 2006;34(10):2596-602.
  4. Kibe S, Adams K, Barlow G. Diagnostic and prognostic biomarkers of sepsis in critical care. J Antimicrob Chemother. 2011;66(Suppl 2):ii33-40.
  5. Valdez-Costeira R, Huerta-Romano JF. Utilidad de procalcitonina en niños con infección sistémica (primera de dos partes). Rev Mex Pediatría. 2011;78(4):147-51.
  6. Meisner M. Update on procalcitonin measurements. Ann Lab Med. 2014;34(4):263-73.
  7. Gómez-Rivera N, Molina-Moreno FA, García-Zarate MG, Castillo-Ramos J, García-Hernández RJ, Vázquez-Pizaña E, et al. Procalcitonina semicuantitativa (PCT-Q) como prueba diagnóstica y marcador pronóstico en niños con sepsis bacteriana. Bol Méd Hosp Infant México. 2006;63(1):8-17.
  8. Han YY, Doughty LA, Kofos D, Sasser H, Carcillo JA. Procalcitonin is persistently increased among children with poor outcome from bacterial sepsis. Pediatr Crit Care Med J Soc Crit Care Med World Fed Pediatr Intensive Crit Care Soc. 2003;4(1):21-5.
  9. Pundiche M, Sârbu V, Unc OD, Grasa C, Martinescu A, Bădărău V, et al. [Role of procalcitonin in monitoring the antibiotic therapy in septic surgical patients]. Chir Buchar Rom 1990. 2012;107(1):71-8.
  10. Soni NJ, Samson DJ, Galaydick JL, Vats V, Huang ES, Aronson N, et al. Procalcitonin-guided antibiotic therapy: a systematic review and meta-analysis. J Hosp Med. 2013;8(9):530-40.
  11. Saeed K, Dryden M, Bourne S, Paget C, Proud A. Reduction in antibiotic use through procalcitonin testing in patients in the medical admission unit or intensive care unit with suspicion of infection. J Hosp Infect. 2011;78(4):289-92.
  12. Liu B, Li H, Lei Y, Zhao S, Sun M. [Clinical significance of dynamic monitoring of procalcitonin in guiding the use of antibiotics in patients with sepsis in ICU]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2013;25(11):690-3.
  13. Haubitz S, Mueller B, Schuetz P. Streamlining antibiotic therapy with procalcitonin protocols: consensus and controversies. Expert Rev Respir Med. 2013;7(2):145-57.
  14. Wang T, Wang Z, Wang L, Yan L, Wan J, Zhang S, et al. CRISPLD2 is expressed at low levels during septic shock and is associated with procalcitonin. PloS One. 2013;8(6):e65743.
  15. Viallon A, Guyomarc’h S, Marjollet O, Berger C, Carricajo A, Robert F, et al. Can emergency physicians identify a high mortality subgroup of patients with sepsis: role of procalcitonin. Eur J Emerg Med Off J Eur Soc Emerg Med. 2008;15(1):26-33.
  16. Su L, Meng K, Zhang X, Wang H, Yan P, Jia Y, et al. Diagnosing ventilator-associated pneumonia in critically ill patients with sepsis. Am J Crit Care Off Publ Am Assoc Crit-Care Nurses. 2012;21(6):e110-119.
  17. Prkno A, Wacker C, Brunkhorst FM, Schlattmann P. Procalcitonin-guided therapy in intensive care unit patients with severe sepsis and septic shock--a systematic review and meta-analysis. Crit Care Lond Engl. 2013;17(6):R291.
  18. Pettilä V, Hynninen M, Takkunen O, Kuusela P, Valtonen M. Predictive value of procalcitonin and interleukin 6 in critically ill patients with suspected sepsis. Intensive Care Med. 2002;28(9):1220-5.
  19. Magrini L, Travaglino F, Marino R, Ferri E, De Berardinis B, Cardelli P, et al. Procalcitonin variations after Emergency Department admission are highly predictive of hospital mortality in patients with acute infectious diseases. Eur Rev Med Pharmacol Sci. 2013;17(Suppl 1):133-42.
  20. Li Z, Wang H, Liu J, Chen B, Li G. Serum soluble triggering receptor expressed on myeloid cells-1 and procalcitonin can reflect sepsis severity and predict prognosis: a prospective cohort study. Mediators Inflamm. 2014;2014:641039.
  21. Jain S, Sinha S, Sharma SK, Samantaray JC, Aggrawal P, Vikram NK, et al. Procalcitonin as a prognostic marker for sepsis: a prospective observational study. BMC Res Notes. 2014;7:458.
  22. Clec’h C, Fosse J-P, Karoubi P, Vincent F, Chouahi I, Hamza L, et al. Differential diagnostic value of procalcitonin in surgical and medical patients with septic shock. Crit Care Med. 2006;34(1):102-7.
  23. Clec’h C, Ferriere F, Karoubi P, Fosse JP, Cupa M, Hoang P, et al. Diagnostic and prognostic value of procalcitonin in patients with septic shock. Crit Care Med. 2004;32(5):1166-9.
  24. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39(2):165-228.
  25. Hatherill M, Tibby SM, Turner C, Ratnavel N, Murdoch IA. Procalcitonin and cytokine levels: relationship to organ failure and mortality in pediatric septic shock. Crit Care Med. 2000;28(7):2591-4.
  26. Casado-Flores J, Blanco-Quirós A, Asensio J, Arranz E, Garrote JA, Nieto M. Serum procalcitonin in children with suspected sepsis: a comparison with C-reactive protein and neutrophil count. Pediatr Crit Care Med. 2003;4(2):190-5.
  27. Jain S, Sinha S, Sharma SK, Samantaray JC, Aggrawal P, Vikram NK, et al. Procalcitonin as a prognostic marker for sepsis: a prospective observational study. BMC Res Notes. 2014;7:458.
  28. Grozdanovski K, Milenkovic Z, Demiri I, Spasovska K, Cvetanovska M, Kirova-Urosevic V. Early prognosis in patients with community-acquired severe sepsis and septic shock: analysis of 184 consecutive cases. Prilozi. 2012;33(2):105-16.
  29. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546-54.
  30. Fortenberry JD, Paden ML, Goldstein SL. Acute kidney injury in children: an update on diagnosis and treatment. Pediatr Clin North Am. 2013;60(3):669-88.
  31. Jones KDJ, Berkley JA. Severe acute malnutrition and infection. Paediatr Int Child Health. 2014;34(sup1):S1-29.
  32. Ibrahim MK, Zambruni M, Melby CL, Melby PC. Impact of Childhood Malnutrition on Host Defense and Infection. Clin Microbiol Rev. 2017;30(4):919-71.
  33. Randolph AG, McCulloh RJ. Pediatric sepsis: important considerations for diagnosing and managing severe infections in infants, children, and adolescents. Virulence. 2014;5(1):179-89.
  34. Fitzgerald JC, Basu RK, Akcan-Arikan A, Izquierdo LM, Piñeres Olave BE, Hassinger AB, et al. Acute Kidney Injury in Pediatric Severe Sepsis: An Independent Risk Factor for Death and New Disability. Crit Care Med. 2016;44(12):2241-50.

Downloads

Download data is not yet available.