Interleukin-6 and procalcitonin in children with sepsis and septic shock.
OBJECTIVE
To examine the behavior of interleukin-6 (IL-6) and procalcitonin (PCT) and verify whether they can be used to differentiate children with septic conditions.


METHODS
Septic children aged between 28 days and 14 years, prospectively enrolled from 01/2004 to 12/2005, were divided into sepsis (SG; n=47) and septic shock (SSG; n=43) groups. IL-6 and PCT were measured at admission (T0) and 12h later (T12h). PCT results were classed as: 0.5 ng/mL=sepsis unlikely; > or =0.5 to <2=sepsis possible; > or =2 to <10=systemic inflammation; > or =10=septic shock.


RESULTS
Ninety children were included. At T0, there was a higher frequency of SSG with higher PCT compared with SG [SSG: 30 (69.7%)>SG: 14 (29.8%); p<0.05]. Similar results were observed at T12h. PRISM was significantly higher for SSG patients with higher PCT than SG patients. At T0, IL-6 levels were higher in SSG [SSG: 213.10 (10.85-396.70)>SG: 63.21 (0.86-409.82); p=0.001], but not statistically different at T12h. IL-6 levels positively correlated with PRISM score in SSG patients at admission (p=0.001; r=0.86).


CONCLUSIONS
PCT and IL-6 appear to be helpful in early assessment of pediatric sepsis, are of diagnostic value at admission, and are related to disease severity.
Pediatric Intensive Care Unit, Pediatrics Department, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil. jrf@fmb.unesp.br
José R
JR
Fioretto
Joelma G
JG
Martin
Cilmery S
CS
Kurokawa
Mário F
MF
Carpi
Rossano C
RC
Bonatto
Sandra M Q
SM
Ricchetti
Marcos A
MA
de Moraes
Carlos R
CR
Padovani
D000293:Adolescent; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000097:blood* / Q000473:pathology; D013997:Time Factors
C000606589:CALCA protein, human; D015850:Interleukin-6; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide