title: Procalcitonin: a useful biomarker to discriminate infection after cardiopulmonary bypass in children.
abstract: OBJECTIVE
  To determine whether procalcitonin discriminates between postcardiopulmonary bypass inflammatory syndrome and infectious complication in children better than does C-reactive protein.
  
  
  METHODS
  Prospective study of children admitted to the intensive care unit after cardiopulmonary bypass.
  
  
  METHODS
  Classified according to a diagnosis of systemic inflammatory response syndrome and bacterial infection or systemic inflammatory response syndrome but no bacterial infection. Two hundred thirty-one cases were recruited.
  
  
  RESULTS
  Procalcitonin, C-reactive protein, and leukocyte count were measured daily from surgery until day 3. Twenty-two patients were infected (9.5%). Significant differences were detected in the procalcitonin values of the infected group vs. the noninfected group, especially at day 2 (p = .000). There were no differences in the C-reactive protein values. The optimal cutoff for procalcitonin was >2 ng/mL at day 1 and above 4 ng/mL at the day 2. There was a greater sensitivity and specificity than with C-reactive protein as an infection predictor.
  
  
  CONCLUSIONS
  Procalcitonin is useful in the diagnosis of bacterial infection after cardiopulmonary bypass. Because procalcitonin kinetics are different in postcardiopulmonary bypass patients, the cutoff to diagnose infection should be different from the normal cutoff.
authors.affiliation: Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona, Spain. ijordan@hsjdbcn.org
authors.forename: Iolanda Jordan
authors.initials: IJ
authors.lastname: Garcia
authors.forename: Mònica B
authors.initials: MB
authors.lastname: Gargallo
authors.forename: Elisabeth E
authors.initials: EE
authors.lastname: Torné
authors.forename: Francisco José Cambra
authors.initials: FJ
authors.lastname: Lasaosa
authors.forename: Anna T
authors.initials: AT
authors.lastname: Viñas
authors.forename: Carme V
authors.initials: CV
authors.lastname: Tolosa
authors.forename: Antonio P
authors.initials: AP
authors.lastname: Rico
mesh_terms: D000293:Adolescent; D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count; D008297:Male; D011498:Protein Precursors / Q000097:blood*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide