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.
Fioretto
José R
JR
Pediatric Intensive Care Unit, Pediatrics Department, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil. jrf@fmb.unesp.br
Martin
Joelma G
JG
Kurokawa
Cilmery S
CS
Carpi
Mário F
MF
Bonatto
Rossano C
RC
Ricchetti
Sandra M Q
SM
de Moraes
Marcos A
MA
Padovani
Carlos R
CR
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