Procalcitonin and C-reactive protein kinetics in postoperative pediatric cardiac surgical patients.
OBJECTIVE
To determine the kinetics of procalcitonin (PCT) and C-reactive protein (CRP) concentration after pediatric cardiac surgery with cardiopulmonary bypass.


METHODS
Prospective, clinical cohort study.


METHODS
A fifteen-bed tertiary-care pediatric intensive care unit.


METHODS
Fourteen pediatric patients admitted for cardiac surgery.


RESULTS
Serum PCT and CRP were measured before cardiopulmonary bypass (CPB); after CPB; and on the first, second, and third days after surgery by means of immunoluminometry and nephelometry, respectively. Reference values for systemic inflammatory response syndrome are 0.5 to 2.0 ng/mL for PCT and <5 mg/L for CRP. Baseline serum PCT and CRP concentrations were 0.24 +/- 0.13 ng/mL and 4.06 +/- 3.60 mg/L (median 25th percentile-75th percentile), respectively. PCT concentrations increased progressively from the end of CPB (0.62 +/- 0.30 ng/mL), peaked at 24 hours postoperatively (POD1) (0.77 +/- 0.49 ng/mL), and began to decrease at 48 hours or POD2 (0.35 +/- 0.21 ng/mL). CRP increased just after CPB (58.82 +/- 42.23 mg/L) and decreased after 72 hours (7.09 +/- 9.81 mg/L).


CONCLUSIONS
An increment of both PCT and CRP was observed just after CPB. However, PCT values remained within reference values, whereas CRP concentrations increased significantly after CPB until the third day. These preliminary results suggest that PCT was more effective than CRP to monitor patients with SIRS and a favorable outcome.
Arkader
Ronaldo
R
Department of Pediatrics, School of Medicine, University of São Paulo, São Paulo, Brazil.
Troster
Eduardo Juan
EJ
Abellan
Deipara Monteiro
DM
Lopes
Marcel Rezende
MR
Júnior
Roberto Raiz
RR
Carcillo
Joseph A
JA
Okay
Thelma Suely
TS
D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000378:metabolism* / Q000493:pharmacokinetics; D002116:Calcitonin / Q000097:blood* / Q000493:pharmacokinetics; D015740:Calcitonin Gene-Related Peptide; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009391:Nephelometry and Turbidimetry; D011184:Postoperative Period; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood* / Q000493:pharmacokinetics; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis; D013997:Time Factors
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide