title: Kinetics of procalcitonin and C-reactive protein and the relationship to postoperative infection in young infants undergoing cardiovascular surgery.
abstract: BACKGROUND
  The utility of procalcitonin (PCT) and C-reactive protein (CRP) as infectious biomarkers following infant cardiothoracic surgery is not well defined.
  
  
  METHODS
  We designed a prospective cohort study to evaluate PCT and CRP after infant cardiothoracic surgery. PCT and CRP were drawn preoperatively and 24/72 h postoperation or daily in delayed sternal closure patients. Presence of infection within 10 d of surgery, vasoactive-inotropic scores at 24 and 72 h, and length of intubation, intensive care unit stay, and hospital stay were documented.
  
  
  RESULTS
  PCT and CRP were elevated at 24 h. PCT then decreased while CRP increased in patients undergoing delayed sternal closure or cardiopulmonary bypass. In the delayed sternal closure group, PCT was significantly higher on postoperative days 2-5 in patients who ultimately developed infection. Higher PCT was independently associated with increased vasoactive-inotropic score at 72 h. CRP did not correlate with infection or postoperative support.
  
  
  CONCLUSIONS
  PCT rises after cardiothoracic surgery in infants but decreases by 72 h while CRP remains elevated. Sternal closure may affect CRP but not PCT. PCT is independently associated with circulatory support requirements at 72 h postoperation and with development of infection. PCT may have greater utility as a biomarker in this population.
authors.affiliation: Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Jesse
authors.initials: J
authors.lastname: Davidson
authors.forename: Suhong
authors.initials: S
authors.lastname: Tong
authors.forename: Amanda
authors.initials: A
authors.lastname: Hauck
authors.forename: D Scott
authors.initials: DS
authors.lastname: Lawson
authors.forename: Eduardo
authors.initials: E
authors.lastname: da Cruz
authors.forename: Jon
authors.initials: J
authors.lastname: Kaufman
mesh_terms: D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects*; D015331:Cohort Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007700:Kinetics; D016014:Linear Models; D008111:Liver Function Tests; D011183:Postoperative Complications / Q000097:blood*; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000097:blood*; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide