Measurements of procalcitonin facilitate targeting of endotoxin adsorption treatment in febrile neutropenic patients suffering from shock.
Immediate initiation of hemoperfusion treatment with polymixin B immobilized fiber (PMX-DHP) is a potent strategy to improve hemodynamics in septic patients with critical circulatory failure. However, it is often difficult to accurately and rapidly differentiate between bacterial infections and non-infectious causes of shock in acutely critically-ill patients. Procalcitonin (PCT) measurements may assist in the early identification of bacterial infection/sepsis and determination of severity in such patients. We present two febrile neutropenic (FN) patients who developed severe shock after chemotherapy for hematological malignancies. PCT levels were markedly elevated in both patients (≥ 10 ng/ml), suggesting a high likelihood of bacterial infectious etiology as the cause of their shock, and thus they were promptly treated with PMX-DHP. Measurements of PCT may facilitate targeting of PMX-DHP treatment among FN patients suffering from shock, which may lead to better prognosis.
Masaki
M
Hara
Ken
K
Tsuchiya
Kosaku
K
Nitta
Minoru
M
Ando
D000327:Adsorption; D000328:Adult; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D004731:Endotoxins / Q000302:isolation & purification*; D064147:Febrile Neutropenia / Q000097:blood / Q000150:complications*; D005260:Female; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008297:Male; D011112:Polymyxin B / Q000008:administration & dosage*; D011498:Protein Precursors / Q000097:blood*; D012772:Shock, Septic / Q000097:blood* / Q000209:etiology / Q000628:therapy
C000606589:CALCA protein, human; D004731:Endotoxins; D011498:Protein Precursors; D002116:Calcitonin; D011112:Polymyxin B; D015740:Calcitonin Gene-Related Peptide