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Lipopolysaccharide-binding protein in critically ill neonates and children with suspected infection: comparison with procalcitonin, interleukin-6, and C-reactive protein

  • Neonatal and Pediatric Intensive Care
  • Published:
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Abstract

Objective

To evaluate markers of infection in critically ill neonates and children, comparing lipopolysaccharide-binding protein (LBP) with procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP).

Design and setting

Prospective, observational study in the level III multidisciplinary neonatal and pediatric intensive care unit.

Patients

Sixty patients with systemic inflammatory response syndrome (SIRS) and suspected infection classified into two groups: SIRS/sepsis (n=33) and SIRS/no sepsis (n=27). We included 29 neonates aged less than 48 h (neonates <48 h), 12 neonates older than 48 h (neonates >48 h), and 19 children. Median disease severity was high in neonates aged under 48 h and moderate in neonates aged over 48 h and children.

Interventions

Serum LBP, PCT, IL-6, and CRP were measured on two consecutive days. Area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and predictive values were evaluated.

Results

Serum LBP was higher in patients with SIRS/sepsis than in patients with SIRS/no sepsis. AUC for LBP on the first day of suspected infection was 0.89 in the younger neonates, 0.93 in the older neonates, and 0.91 in children.

Conclusions

In critically ill neonates aged under 48 h LBP on the first day of suspected infection is a better marker of sepsis than IL-6 and PCT, and is similar to CRP. In critically ill neonates aged over 48 h and children LBP is a better marker than IL-6 and CRP, and is similar to PCT.

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Acknowledgements

This study was supported by The Ministry of Education, Science and Sports, Republic of Slovenia, grant number J3-3482-0312-02. We are indebted to Dipros Co., Kranj, Slovenia, for financial support of LBP measurement.

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Authors and Affiliations

  1. Department of Pediatric Surgery and Intensive Care, University Medical Center Ljubljana, Zaloska 7, 1525, Ljubljana, Slovenia

    Maja Pavcnik-Arnol & Metka Derganc

  2. Department of Nuclear Medicine, University Medical Center Ljubljana, Zaloska 7, 1525, Ljubljana, Slovenia

    Sergej Hojker

Authors
  1. Maja Pavcnik-Arnol
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  2. Sergej Hojker
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  3. Metka Derganc
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Correspondence to Maja Pavcnik-Arnol.

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Pavcnik-Arnol, M., Hojker, S. & Derganc, M. Lipopolysaccharide-binding protein in critically ill neonates and children with suspected infection: comparison with procalcitonin, interleukin-6, and C-reactive protein. Intensive Care Med 30, 1454–1460 (2004). https://doi.org/10.1007/s00134-004-2307-4

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  • DOI: https://doi.org/10.1007/s00134-004-2307-4

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