The Use of Procalcitonin as a Marker of Sepsis in Postoperative and Intensive Care

Overview

The plasmatic levels of procalcitonin is now considered as an objective parameter of severe systemic infection, SIRS and sepsis. We have observedthe dynamics of serum procalcitonin in longitudinal prospective study of 40 oncological patients 3 days after abdominal surgery. We have found outthat the peak values of procalcitonin were on the 1 st postoperative day and in uncomplicated course did not exceed the value 1.44 – 2 ng/ml. We haveobserved 3 cases of severe systemic infection (2 cases of peritonitis 9.9 – 15.5 ng/ml) and 1 case of proven catheter sepsis with gram/positivehemocultures (peak value 54.4 ng/ml). We also observed 3 cases of circulatory failure due to c ardiogenic (7.2 ng/ml), haemorrhagic (11.1 ng/ml) andtraumatic (5.8 ng/ml) shock. The plasmatic levels of procalcitonin correlate well with the clinical course of patients with peritonitis (10 – 20 ng/ml),and sepsis (more than 10 – 20 ng/ml), and circulatory failure (PCT levels between 5 – 10 ng/ml). Daily monitoring of serum procalcitonin is an effectivemethod how to diagnose and follow-up the course of severe systemic bacterial infection, sepsis and circulatory failure.

Key words:
procalcitonin – intensive care – SIRS – sepsis