Early changes of procalcitonin may advise about prognosis and appropriateness of antimicrobial therapy in sepsis

被引：84

作者：

Georgopoulou, Antonia-Panagiota ^{[1
]}

Savva, Athina ^{[2
]}

Giamarellos-Bourboulis, Evangelos J. ^{[2
]}

Georgitsi, Marianna ^{[2
]}

Raftogiannis, Maria ^{[2
]}

Antonakos, Nicolaos ^{[2
]}

Apostolidou, Efterpi ^{[3
]}

Carrer, Dionyssia-Pinelopi ^{[2
]}

Dimopoulos, George ^{[4
]}

Economou, Aggelos ^{[2
]}

Efthymiou, George ^{[5
]}

Galanakis, Nearchos ^{[7
]}

Galani, Labrini ^{[2
]}

Gargalianos, Panagiotis ^{[6
]}

Karaiskos, Ilias ^{[2
]}

Katsenos, Chrisostomos ^{[8
]}

Kavatha, Dimitra ^{[2
]}

Koratzanis, Evangelos ^{[2
]}

Labropoulos, Panagiotis ^{[5
]}

Lada, Malvina ^{[1
]}

Nakos, George ^{[9
]}

Paggalou, Evgenia ^{[10
]}

Panoutsopoulos, George ^{[11
]}

Paraschos, Michael ^{[8
]}

Pavleas, Ioannis ^{[10
]}

Pontikis, Konstantinos ^{[4
]}

Poulakou, Garyfallia ^{[2
]}

Prekates, Athanassios ^{[12
]}

Sybardi, Styliani ^{[4
]}

Theodorakopoulou, Maria ^{[4
]}

Trakatelli, Christina ^{[13
]}

Tsiaoussis, Panagiotis ^{[14
]}

Gogos, Charalambos ^{[15
]}

Giamarellou, Helen ^{[2
]}

Armaganidis, Apostolos ^{[4
]}

Meisner, Michael ^{[16
]}

机构：

[1] Sismanogle Athens Hosp, Dept Internal Med 2, Athens 15126, Greece

[2] Univ Athens, Sch Med, Dept Internal Med 4, Athens 12462, Greece

[3] Protemaida Hosp, Intens Care Unit, Ptolemaida, Greece

[4] Univ Athens, Sch Med, Dept Crit Care 2, Athens 12462, Greece

[5] Nafplion Gen Hosp, Dept Surg, Naflpion 21100, Greece

[6] G Gennimatas Athens Hosp, Dept Internal Med 1, Athens 11527, Greece

[7] Nikaia Gen Hosp, Dept Internal Med 1, Nikaia, Greece

[8] Korgialeneion Benakeion Hosp Athens, Intens Care Unit, Athens 11526, Greece

[9] Univ Ioannina, Sch Med, Dept Crit Care, GR-45110 Ioannina, Greece

[10] Laikon Athens Gen Hosp, Intens Care Unit, Athens 11527, Greece

[11] Thriassio Elefsina Gen Hosp, Dept Internal Med 1, Magoula 19600, Greece

[12] Tzaneion Hosp Piraeus, Intens Care Unit, Piraeus, Greece

[13] Univ Thessaloniki, Dept Med 3, Thessaloniki 54635, Greece

[14] Univ Thessaloniki, Sch Med, Dept Surg 2, Thessaloniki 54635, Greece

[15] Univ Patras, Sch Med, Dept Internal Med 1, Rion 26504, Greece

[16] Hosp Dresden Neustadt, Dept Anaesthesiol & Intens Care Med, D-1129 Dresden, Germany

来源：

JOURNAL OF CRITICAL CARE | 2011年 / 26卷 / 03期

关键词：

Procalcitonin; Sepsis; Prognosis; Guidance of antimicrobials; RESPIRATORY-TRACT INFECTIONS; ANTIBIOTIC-THERAPY; SURVIVING SEPSIS; GUIDELINES; PNEUMONIA; GUIDANCE; CARE;

D O I：

10.1016/j.jcrc.2010.07.012

中图分类号：

R4 [临床医学];

学科分类号：

100218 [急诊医学];

摘要：

Purpose: The objective of this study is to define if early changes of procalcitonin (PCT) may inform about prognosis and appropriateness of administered therapy in sepsis. Methods: A prospective multicenter observational study was conducted in 289 patients. Blood samples were drawn on day 1, that is, within less than 24 hours from advent of signs of sepsis, and on days 3, 7, and 10. Procalcitonin was estimated in serum by the ultrasensitive Kryptor assay (BRAHMS GmbH, Hennigsdorf, Germany). Patients were divided into the following 2 groups according to the type of change of PCT: group 1, where PCT on day 3 was decreased by more than 30% or was below 0.25 ng/mL, and group 2, where PCT on day 3 was either increased above 0.25 ng/mL or decreased less than 30%. Results: Death occurred in 12.3% of patients of group 1 and in 29.9% of those of group 2 (P < .0001). Odds ratio for death of patients of group 1 was 0.328. Odds ratio for the administration of inappropriate antimicrobials of patients of group 2 was 2.519 (P = .003). Conclusions: Changes of serum PCT within the first 48 hours reflect the benefit or not of the administered antimicrobial therapy. Serial PCT measurements should be used in clinical practice to guide administration of appropriate antimicrobials. (C) 2011 Elsevier Inc. All rights reserved.

引用

页码：331.e1 / 331.e7

页数：7

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