Comparison between procalcitonin and C-reactive protein for early diagnosis of children with sepsis or septic shock
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Objective and design
The objective of the paper is to examine the behavior of C-reactive protein (CRP) and procalcitonin (PCT) in the first 12 h of admission and verify which performs better to differentiate children with septic conditions.
Septic children aged between 28 days and 14 years were divided into sepsis (SG; n = 46) and septic shock (SSG; n = 41) groups. CRP and PCT were measured at admission (T0) and 12 h later (T12 h). PCT results were classed as: 0.5 ng/ml = sepsis unlikely; ≥0.5 to <2 = sepsis possible; ≥2 to <10 = systemic inflammation; ≥10 = septic shock.
At T0, there was a higher frequency of SSG with PCT >10 compared to SG [SSG: 30 (73.1%) > SG: 14 (30.4%); P < 0.05]. Similar results were observed at T12 h. Pediatric Risk of Mortality I score was significantly higher for SSG patients with higher PCT than SG patients. CRP levels were not statistically different for groups and time points.
PCT was better than CRP for diagnosing sepsis and septic shock, mainly at admission, and is related to disease severity.
KeywordsProcalcitonin C-reactive protein Septic shock Children Critical care
This study was supported by FAPESP (Fundação de Amparo a Pesquisa do Estado de São Paulo), process number 04/03776-0. We would like to thank the whole team at the PICU and at UNESP Pediatrics Department’s Clinical and Experimental Research Center for helping with data collection and laboratory analyses. We also thank Colin E. Knaggs for text revision.
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