Diagnosis of infection in paediatric veno-arterial cardiac extracorporeal membrane oxygenation: role of procalcitonin and C-reactive protein.

@article{Rungatscher2013DiagnosisOI,
  title={Diagnosis of infection in paediatric veno-arterial cardiac extracorporeal membrane oxygenation: role of procalcitonin and C-reactive protein.},
  author={Alessio Rungatscher and Alberto Merlini and Fabrizio de Rita and Gianluca Lucchese and Luca Barozzi and Giuseppe Faggian and Alessandro Mazzucco and Giovanni Battista Luciani},
  journal={European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery},
  year={2013},
  volume={43 5},
  pages={
          1043-9
        }
}
  • A. Rungatscher, A. Merlini, +5 authors G. Luciani
  • Published 1 May 2013
  • Medicine, Biology
  • European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
OBJECTIVES Plasma concentration of procalcitonin (PCT) and its value in the diagnosis of infection in paediatric patients treated with extracorporeal membrane oxygenation (ECMO) are undefined. This study aimed to define the levels of PCT and C-reactive protein (CRP) in paediatric cardiac ECMO patients and to determine their role in predicting infection, severity of organ dysfunction and clinical outcome. METHODS PCT and CRP plasma concentrations were measured daily in 20 consecutive infants… 
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26 Citations
Background Citations
7
Methods Citations
2
Results Citations
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26 Citations

Citation Type

Citation Type

Predictive Value of Procalcitonin for Infection and Survival in Adult Cardiogenic Shock Patients Treated with Extracorporeal Membrane Oxygenation
TLDR
The change in PCT levels was not useful in predicting the occurrence of new nosocomial infections during the ECMO run, and a PCT level >10 ng/mL during the first week of ECMO support was significantly associated with mortality (p<0.01).
Kinetics of Procalcitonin in Pediatric Patients on Extracorporeal Membrane Oxygenation
TLDR
Procalcitonin does not seem to be modified by ECMO and could be a good biomarker of evolution, and both PCT and CRP did not predict risk of neurologic sequelae or mortality in any group.
Diagnostic Accuracy of Infection Markers to Diagnose Infections in Neonates and Children Receiving Extracorporeal Membrane Oxygenation
TLDR
The diagnosis of infections acquired during ECMO remains challenging and larger prospective studies are needed that also include novel infection markers to improve recognition of infection in patients on ECMO.
Association of procalcitonin values and bacterial infections in pediatric patients receiving extracorporeal membrane oxygenation
TLDR
A PCT value of 0.5 ng/mL had the most utility for determining the absence or presence of a bacterial infection in the setting of ECMO with a high sensitivity and NPV.
Procalcitonin Concentration Measured Within the First Days of Cardiac Surgery Is Predictive of Postoperative Infections in Neonates: A Case–Control Study
TLDR
The accuracy of PCT to identify infections after neonatal cardiac surgery is better than that of CRP when measured within 48 h of surgery, and the sum of the two markers measured early after surgery is an excellent predictor of postoperative infections.
Use of procalcitonin for the prediction and treatment of acute bacterial infection in children
TLDR
Procalcitonin is a reliable serum marker for determining the presence or absence of invasive bacterial infection and response to antibiotic therapy and Tailoring antibiotics to PCT levels may reduce the duration of therapy without increasing treatment failure, but more research is needed in children.
Kinetics of C-reactive protein in children with congenital heart diseases in the early period after cardiosurgical treatment with extracorporeal circulation.
Infection profile in neonatal patients during extracorporeal membrane oxygenation
TLDR
The factors that increase the risk of infection are lower birth weight, vaginal birth, duration of extracorporeal membrane oxygenation, and a positive trend of white blood cell 72 h prior to infection/suspicion.
[Procalcitonin for the differential diagnosis of infectious and non-infectious systemic inflammatory response syndrome after cardiac operation].
TLDR
PCT was more reliable than CRP in diagnosing severe sepsis without shock, but it was ineffective for diagnosing septic shock.
Monitoring both procalcitonin and C-reactive protein in the early period after tetralogy of Fallot correction in children promotes rational antibiotic use.
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References

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TLDR
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TLDR
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