Infection…what else? The usefulness of procalcitonin in children after cardiac surgery

<h4>Objectives</h4> Procalcitonin is a useful biomarker for predicting bacterial infection after cardiac surgery. However, sometimes procalcitonin rises following cardiac surgery without a confirmation of bacterial infection. The aim was to analyse procalcitonin levels in children withou...

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Autores principales:	Sara Bobillo-Perez, Monica Girona-Alarcon, Anna Sole-Ribalta, Carmina Guitart, Aida Felipe, Lluisa Hernandez, Monica Balaguer, Francisco Jose Cambra, Iolanda Jordan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ff5b81729cb042a2bddebe737f92a8d7
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spelling	oai:doaj.org-article:ff5b81729cb042a2bddebe737f92a8d72021-11-04T06:07:11ZInfection…what else? The usefulness of procalcitonin in children after cardiac surgery1932-6203https://doaj.org/article/ff5b81729cb042a2bddebe737f92a8d72021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8535444/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objectives</h4> Procalcitonin is a useful biomarker for predicting bacterial infection after cardiac surgery. However, sometimes procalcitonin rises following cardiac surgery without a confirmation of bacterial infection. The aim was to analyse procalcitonin levels in children without a bacterial infection after cardiac surgery. <h4>Study design</h4> This is a prospective, observational study of children <18 years old admitted to the pediatric intensive care unit after cardiac surgery. <h4>Results</h4> 1,042 children were included, 996 (95.6%) without a bacterial infection. From them, severe complications occurred in 132 patients (13.3%). Procalcitonin increased differentially depending on the type of complication. Patients who presented a poor outcome (n = 26, 2.6%) had higher procalcitonin values in the postoperative period than the rest of patients (<24 hours: 5.8 ng/mL vs. 0.6 ng/mL; 24–48 hours, 5.1 ng/mL vs. 0.8 ng/mL, and 48–72 hours, 5.3 ng/mL vs. 1.2 ng/mL), but these values remained stable over time (p = 0.732; p = 0.110). The AUC for procalcitonin for predicting poor outcome was 0.876 in the first 24 hours. The cut-off point to predict poor outcome was 2 ng/mL in the first 24 hours (sensitivity 86.9%, specificity 77.3%). Patients with bacterial infection (n = 46) presented higher values of procalcitonin initially, but they decreased in the 48–72 hours period (<24 hours: 4.9 ng/mL; 24–48 hours, 5.8 ng/mL, and 48–72 hours, 4.5 ng/mL). <h4>Conclusions</h4> A procalcitonin value<2 ng/mL may indicate the absence of infection and poor outcome after cardiac surgery. The evolution of the values of this biomarker might help to discern between infection (where procalcitonin will decrease) and poor outcome (where procalcitonin will not decrease).Sara Bobillo-PerezMonica Girona-AlarconAnna Sole-RibaltaCarmina GuitartAida FelipeLluisa HernandezMonica BalaguerFrancisco Jose CambraIolanda JordanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sara Bobillo-Perez Monica Girona-Alarcon Anna Sole-Ribalta Carmina Guitart Aida Felipe Lluisa Hernandez Monica Balaguer Francisco Jose Cambra Iolanda Jordan Infection…what else? The usefulness of procalcitonin in children after cardiac surgery
description	<h4>Objectives</h4> Procalcitonin is a useful biomarker for predicting bacterial infection after cardiac surgery. However, sometimes procalcitonin rises following cardiac surgery without a confirmation of bacterial infection. The aim was to analyse procalcitonin levels in children without a bacterial infection after cardiac surgery. <h4>Study design</h4> This is a prospective, observational study of children <18 years old admitted to the pediatric intensive care unit after cardiac surgery. <h4>Results</h4> 1,042 children were included, 996 (95.6%) without a bacterial infection. From them, severe complications occurred in 132 patients (13.3%). Procalcitonin increased differentially depending on the type of complication. Patients who presented a poor outcome (n = 26, 2.6%) had higher procalcitonin values in the postoperative period than the rest of patients (<24 hours: 5.8 ng/mL vs. 0.6 ng/mL; 24–48 hours, 5.1 ng/mL vs. 0.8 ng/mL, and 48–72 hours, 5.3 ng/mL vs. 1.2 ng/mL), but these values remained stable over time (p = 0.732; p = 0.110). The AUC for procalcitonin for predicting poor outcome was 0.876 in the first 24 hours. The cut-off point to predict poor outcome was 2 ng/mL in the first 24 hours (sensitivity 86.9%, specificity 77.3%). Patients with bacterial infection (n = 46) presented higher values of procalcitonin initially, but they decreased in the 48–72 hours period (<24 hours: 4.9 ng/mL; 24–48 hours, 5.8 ng/mL, and 48–72 hours, 4.5 ng/mL). <h4>Conclusions</h4> A procalcitonin value<2 ng/mL may indicate the absence of infection and poor outcome after cardiac surgery. The evolution of the values of this biomarker might help to discern between infection (where procalcitonin will decrease) and poor outcome (where procalcitonin will not decrease).
format	article
author	Sara Bobillo-Perez Monica Girona-Alarcon Anna Sole-Ribalta Carmina Guitart Aida Felipe Lluisa Hernandez Monica Balaguer Francisco Jose Cambra Iolanda Jordan
author_facet	Sara Bobillo-Perez Monica Girona-Alarcon Anna Sole-Ribalta Carmina Guitart Aida Felipe Lluisa Hernandez Monica Balaguer Francisco Jose Cambra Iolanda Jordan
author_sort	Sara Bobillo-Perez
title	Infection…what else? The usefulness of procalcitonin in children after cardiac surgery
title_short	Infection…what else? The usefulness of procalcitonin in children after cardiac surgery
title_full	Infection…what else? The usefulness of procalcitonin in children after cardiac surgery
title_fullStr	Infection…what else? The usefulness of procalcitonin in children after cardiac surgery
title_full_unstemmed	Infection…what else? The usefulness of procalcitonin in children after cardiac surgery
title_sort	infection…what else? the usefulness of procalcitonin in children after cardiac surgery
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ff5b81729cb042a2bddebe737f92a8d7
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Infection…what else? The usefulness of procalcitonin in children after cardiac surgery

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