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Procalcitonin and C-reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children

  • Pediatric Original
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An Erratum to this article was published on 26 April 2007

Abstract

Objectives

To analyse the clinical value of procalcitonin (PCT), C-reactive protein (CRP) and leucocyte count in the diagnosis of paediatric sepsis and in the stratification of patients according to severity.

Design

Prospective, observational study.

Setting

Paediatric intensive care unit (PICU).

Patients

Ninety-four children.

Measurement and results

Leucocyte count, PCT and CRP were measured when considered necessary during the PICU stay. Patients were classified, when PCT and CRP were measured, into one of six categories (negative, SIRS, localized infection, sepsis, severe sepsis, and septic shock) according to the definitions of the American College of Chest Physicians /Society of Critical Care Medicine. A total of 359 patient day episodes were obtained. Leucocyte count did not differ across the six diagnostic classes considered. Median plasma PCT concentrations were 0.17, 0.43, 0.79, 1.80, 15.40 and 19.13 ng/ml in negative, systemic inflammatory response syndrome (SIRS), localized infection, sepsis, severe sepsis, and septic shock groups, respectively, whereas median plasma CRP concentrations were 1.35, 3.80, 6.45, 5.70, 7.60 and 16.2 mg/dl, respectively. The area under the ROC curve for the diagnosis of septic patients was 0.532 for leucocyte count (95% CI, 0.462–0.602), 0.750 for CRP (95% CI, 0.699–0.802) and 0.912 for PCT (95% CI, 0.882–0.943). We obtained four groups using CRP values and five groups using PCT values that classified a significant percentage of patients according to the severity of the different SIRS groups.

Conclusions

PCT is a better diagnostic marker of sepsis in critically ill children than CRP. The CRP, and especially PCT, may become a helpful clinical tool to stratify patients with SIRS according to disease severity.

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Acknowledgements

The authors gratefully acknowledge the assistance of the medical and nursing staff of the PICU of Hospital Universitario Central de Asturias.

Author information

Authors and Affiliations

  1. Department of Paediatrics, Paediatric Intensive Care Unit, Hospital Universitario Central de Asturias, University of Oviedo, Celestino Villamil s/n., 33006, Oviedo, Spain

    Corsino Rey, Andrés Concha, Alberto Medina & Soledad Prieto

  2. Hospital Alvarez-Buylla, Belonga s/n., 33600, Mieres, Spain

    Marta Los Arcos

  3. Academic Multidisciplinary Unit of Agronomy and Science, University of Tamaulipas, Adolfo López Mateos, 87149 CD, Victoria, Tamaulipas, Mexico

    Pablo Martinez

  4. Biochemical Laboratory, Hospital Universitario Central de Asturias, University of Oviedo, Celestino Villamil s/n., 33006, Oviedo, Spain

    Belen Prieto

Authors
  1. Corsino Rey
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  2. Marta Los Arcos
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  3. Andrés Concha
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  4. Alberto Medina
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  5. Soledad Prieto
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  6. Pablo Martinez
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Corresponding author

Correspondence to Corsino Rey.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00134-007-0650-y

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Rey, C., Los Arcos, M., Concha, A. et al. Procalcitonin and C-reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children. Intensive Care Med 33, 477–484 (2007). https://doi.org/10.1007/s00134-006-0509-7

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  • DOI: https://doi.org/10.1007/s00134-006-0509-7

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