Diagnostic potential of neutrophil elastase inhibitor complex in the routine care of critically ill newborn infants
| Autor: | David Nadal, Martin Janousek, Sergio Fanconi, Joachim E. Fischer, Anna Brunner, Nenad Blau |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
Inhibitor complex Critical Illness Gastroenterology Sensitivity and Specificity law.invention Sepsis Cohort Studies law Internal medicine medicine Humans Prospective Studies Prospective cohort study biology Critically ill business.industry C-reactive protein Infant Newborn medicine.disease Intensive care unit Enzyme inhibitor Neutrophil elastase alpha 1-Antitrypsin Pediatrics Perinatology and Child Health Immunology biology.protein business Leukocyte Elastase |
| Zdroj: | European journal of pediatrics. 159(9) |
| ISSN: | 0340-6199 |
| Popis: | It has been suggested that determination of the neutrophil elastase alpha1-proteinase inhibitor complex (E-alpha1PI) improves the diagnosis of bacterial infection in newborns. We evaluated the use of E-alpha1PI measurements in 143 newborns, consecutively admitted to a tertiary intensive care unit, employing a new random access assay and a sampling procedure that minimises post-collection artefacts. The 95% range for noninfected newborns was 20-110 microg/l up to the 5th day of life and 20-85 microg/l thereafter. The sensitivity as to the diagnosis of culture-proven bloodstream infection was 80% for E-alpha1PI, 86% for the immature to total neutrophil ratio, 64% for C-reactive protein and 37% for the total white blood cell count. The corresponding specificity amounted to 97%, 85%, 85% and 86%, respectively. E-alpha1PI increases preceded elevations of C-reactive protein by 18 h. Like C-reactive protein, E-alpha1PI levels did not distinguish between bloodstream infection and non-bacterial inflammatory responses. Results of E-alpha1PI became available within 1 h of collection and usually 2-3 h before manual leucocyte counts.Determination of neutrophil elastase alpha1-proteinase inhibitor levels yields diagnostic advantages comparable to those of manual differential counts but provide faster turnaround times. |
| Databáze: | OpenAIRE |
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