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Title: Infection¿what else? The usefulness of procalcitonin in children after cardiac surgery
Author: Bobillo Pérez, Sara
Girona Alarcón, Mònica
Solé Ribalta, Anna
Guitart, Carmina
Felipe Villalobos, Aida
Hernández Platero, Lluisa
Balaguer Gargallo, Mònica
Cambra Lasaosa, Francisco José
Jordán García, Iolanda
Keywords: Infants
Cirurgia cardíaca
Infeccions en els infants
Marcadors bioquímics
Heart surgery
Infection in children
Biochemical markers
Issue Date: 22-Oct-2021
Publisher: Public Library of Science (PLoS)
Abstract: Objectives: 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. Study design: This is a prospective, observational study of children <18 years old admitted to the pediatric intensive care unit after cardiac surgery. Results: 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). Conclusions: 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).
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It is part of: PLoS One, 2021, vol. 16, num. 10, p. e0254757
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)

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