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. 2011:2011:594645.
doi: 10.1155/2011/594645. Epub 2011 May 15.

In Critically Ill Patients, Serum Procalcitonin Is More Useful in Differentiating between Sepsis and SIRS than CRP, Il-6, or LBP

Iwan A Meynaar  1 , Wouter Droog, Manou Batstra, Rolf Vreede, Paul Herbrink
Affiliations

In Critically Ill Patients, Serum Procalcitonin Is More Useful in Differentiating between Sepsis and SIRS than CRP, Il-6, or LBP

Iwan A Meynaar et al. Crit Care Res Pract. 2011.

Abstract

We studied the usefulness of serum procalcitonin (PCT), interleukin-6 (IL-6), lipopolysaccharide binding protein (LBP) levels and C-reactive protein (CRP) levels, in differentiating between systemic inflammatory response syndrome (SIRS) and sepsis in critically ill patients. Methods. In this single centre prospective observational study we included all consecutive patients admitted with SIRS or sepsis to the ICU. Blood samples for measuring CRP, PCT, IL-6 and LBP were taken every day until ICU discharge. Results. A total of 76 patients were included, 32 with sepsis and 44 with SIRS. Patients with sepsis were sicker on admission and had a higher mortality. CRP, PCT, IL-6 and LBP levels were significantly higher in patients with sepsis as compared to SIRS. With PCT levels in the first 24 hours after ICU admission <2 ng/mL, sepsis was virtually excluded (negative predictive value 97%). With PCT >10 ng/mL, sepsis with bacterial infection was very likely (positive predictive value 88%). PCT was best at discriminating between SIRS and sepsis with the highest area under the ROC curve (0.95, 95% CI 0.90-0.99). Discussion. This study showed that PCT is more useful than LBP, CRP and IL-6 in differentiating sepsis from SIRS.

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Figures

Figure 1
Figure 1
ROC curve and areas under the curve for diagnosing sepsis with the highest values in the first 24 hours after ICU admission for CRP, PCT, IL-6, and LBP.
Figure 2
Figure 2
Median CRP, PCT, LBP, and IL-6 levels in patients with sepsis and SIRS during ICU admission.
See this image and copyright information in PMC

References

    1. Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest. 1992;101(6):1644–1655. - PubMed
    1. Dellinger RP, Levy MM, Carlet JM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Critical Care Medicine. 2008;36(1):296–327. - PubMed
    1. Pierrakos C, Vincent J-L. Sepsis biomarkers: a review. Critical Care. 2010;14(1, article R15) - PMC - PubMed
    1. Brunkhorst FM, Wegscheider K, Forycki ZF, Brunkhorst R. Procalcitonin for early diagnosis and differentation of SIRS, sepsis, severe sepsis, and septic shock. Intensive Care Medicine. 2000;26(2):S148–S152. - PubMed
    1. Clec’h C, Ferriere F, Karoubi P, et al. Diagnostic and prognostic value of procalcitonin in patients with septic shock. Critical Care Medicine. 2004;32(5):1166–1169. - PubMed