Procalcitonin Concentration Measured Within the First Days of Cardiac Surgery Is Predictive of Postoperative Infections in Neonates: A Case-Control Study
| Autor: | S Vicca, A Di Marzio, M Pontailler, O Guillard, M Bojan, A Aryafar |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Inflammatory response 030204 cardiovascular system & hematology Sensitivity and Specificity Procalcitonin law.invention 03 medical and health sciences 0302 clinical medicine Postoperative Complications law Cardiopulmonary bypass Medicine Humans In patient Postoperative Period Cardiac Surgical Procedures Retrospective Studies Cross Infection Cardiopulmonary Bypass business.industry Case-control study Infant Newborn Cardiac surgery 030228 respiratory system Anesthesia Case-Control Studies Pediatrics Perinatology and Child Health Deep hypothermic circulatory arrest Female Cardiology and Cardiovascular Medicine business Protein concentration hormones hormone substitutes and hormone antagonists Biomarkers |
| Zdroj: | Pediatric cardiology. 40(6) |
| ISSN: | 1432-1971 |
| Popis: | Increased procalcitonin concentration (PCT) is known to be reliable for the identification of infections even in the presence of the non-specific systemic inflammatory response seen after cardiopulmonary bypass (CPB), whereas increased C-reactive protein concentration (CRP) is not. The present work explored the ability of neonate PCT measured early after cardiac surgery to identify postoperative infections. This was a retrospective case–control study, where PCT was matched between patients with and without infections according to the patient’s age, the CPB length, the use of deep hypothermic circulatory arrest (DHCA), and the postoperative day (POD). The accuracy in the prediction of infections was ascertained and cutoff thresholds were identified. 144 neonates were eligible, and 89 pairs of measurements from 94 patients were analyzed. PCT was a good predictor of infections within POD4, and was a better predictor when compared with CRP at POD1 and POD2. The sum of PCT (pg mL−1) and CRP (mg L−1) > 33 on POD1 or POD2 predicted infections with a 0.68 sensitivity and a 0.82 specificity, and a sum > 49.36 on POD3 or POD4 predicted infections with a 0.82 sensitivity and a 0.93 specificity. In patients with DHCA, PCT was higher than in those without DHCA, and was not predictive of infections. The accuracy of PCT to identify infections after neonatal cardiac surgery is better than that of CRP when measured within 48 h of surgery. The sum of the two markers measured early after surgery is an excellent predictor of postoperative infections. |
| Databáze: | OpenAIRE |
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