Procalcitonin as a Predictor of Trauma Severity and Post-traumatic Sepsis in Children

LIU Shao-feng, YUAN Gao-pin, YANG Jian, HE Tao-zhen, FENG Hai-huan, LIU Min

Abstract


To determine the association of procalcitonin (PCT) with trauma severity and post-traumatic sepsis in children. Methods The blood samples of 30 children with acute trauma in a Pediatric unit were collected for four consecutive days. The levels of PCT, IL-6, CRP and WBC were measured. The pediatric trauma score (PTS), length of stay in hospital, incidence of sepsis and clinical outcomes of the children were recorded. The value of PCT for predicting prognosis of children with trauma was compared with other inflammatory markers. Results Plasma PCT levels increased significantly in the patients in our study. Sepsis occurred in 23.33% of the patients. The patients with sepsis had higher levels of PCT than those with and without systemic inflammatory response syndrome (SIRS) and the healthy controls (P<0.05). The peak level of PCT emerged on day 2 after trauma. The plasma PCT levels were positively correlated with trauma severity. The level of PCT on day 2 was an independent predictor for post-trauma sepsis and SIRS. Conclusion Plasma PCT levels increase markedly in post-trauma children. Plasma PCT of day 2 after trauma is an independent predictor of post-traumatic sepsis and SIRS complications. There is a significant correlation between the severity of injury and plasma PCT.

 

Keywords: Procalcitonin, Trauma, Sepsis, Systemic inflammatory response syndrome, Peadiatric trauma score

 

Full Text:

PDF


References


Kochanek KD, Kirmeyer SE. Martin JA, et al. Annual summary of vital statistics; 2009. Pediatrics, 2012; 129 ( 2 ): 338-348.

Meisner M, Adina H, Schmidt J. Correlation of procalcitonin and C-reactive protein to inflammation, complications, and outcome during the intensive care unit course of multiple- trauma patients. Crit Care,2006; 10(1); Rl.

Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med,2001 ;345( 19): 1368-1377.

Goldstein B, Giroir B, Randolph A, et al. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunctionin pediatrics. Pediatr Crit Care Med, 2005; 6 : 2-8.

Tepas JJ, Mollitt DL, Talbert JL,el al. The pediatric trauma score as a predictor of injury severity in the injured child. J Pediatr Surg. 1987;22( 1): 14-18.

Assicot M, Gendrel D. Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet ,1993;341 (8844) :515-518.

Mimoz O, Benoist JF, Edouard AR, el al. Procalcitonin and C-reactive protein during the early posttraumatic systemic inflammatory response syndrome. Intensive Care Med. 1998;24(2):185-188.

Wanner CA, Keel M, Steckholzer U. Relationship between procalcitonin plasma levels and severity of injury, sepsis, organ failure, and mortality in injured patients. Crit Care Med.2000; 28(4):950-957.

Hensler T, Sauerland S, Lefering R, et al. The clinical value of procalcitonin and neopterin in predicting sepsis and organ failure after major trauma. Shock,2003;20(5) ;420-426.

Becker KL, Snider R, Nylen ES. Procalcitonin assay in systemic inflammation, infection, and sepsis: clinical utility and limitations. Crit Care Med,2008;36(3):941-952.

Uzzan B, Cohen R, Nicolas P, et al. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma; a systematic review and meta-analysis. Crit Care Med.2006;34(7):1996-2003.

Simon L. Saint-Louis P. Amre DK .et al. Procalcitonin and C- reactive protein as markers of bacterial infection in critically ill children at onset of systemic inflammatory response syndrome. Pediatr Crit Care Med,2008;9(4):407-413.

Benoist JF. Mimoz O. Assicot M. elal. Serum procalcitonin, but not c-reactive protein, identifies sepsis in trauma patients. Clin Chem, 1998; 44(8 Pt 1): 1778-1779.

Haasper С, Kalmbach M. Dikos СD, elal. Prognostic value of procalcitonin (PCT) and/or interleukin-6 (IL-6) plasma levels after multiple trauma for the development of multi organ dysfunction syndrome (MODS) or sepsis. Technol Health Care.2010;18(2):89-100.


Refbacks

  • There are currently no refbacks.