title: Clinical Applications of Procalcitonin in Pediatrics: An Advanced Biomarker for Inflammation and Infection-Can It Also Be Used in Trauma?
abstract: Background. Procalcitonin is a small molecular peptide that has gained increased support as an adjunct diagnostic marker of infection in the adult population; the concordant body of evidence for the use of procalcitonin in pediatric populations is far less complete. Objectives. Our objective is to review the current evidence supporting the utilization of procalcitonin in children in a variety of clinical scenarios including SIRS, sepsis, burns, and trauma and to identify existing knowledge gaps. Methods. A thorough review of the literature was performed utilizing PubMed. We focused on using meta-analysis from adult populations to review current practices in interpretation and methodology and find concordant pediatric studies to determine if the same applications are validated in pediatric populations. Results. Current evidence supports the usage of procalcitonin as both a sensitive and a specific marker for the differentiation of systemic inflammatory response syndrome from sepsis in pediatrics with increased diagnostic accuracy compared to commonly used biomarkers including complete blood counts and C-reactive protein. Conclusions. Although the body of evidence is limited, initial observations suggest that procalcitonin can be used in pediatric trauma and burn patients as both a prognostic and a diagnostic marker, aiding in the identification of infection in patients with extensive underlying inflammation.
authors.affiliation: Department of Pediatrics, St. Christopher's Hospital for Children, 3601 A Street, Philadelphia, PA 19134, USA.
authors.forename: Ioannis
authors.identifier: 0000-0002-8396-9022
authors.initials: I
authors.lastname: Koutroulis
authors.affiliation: Department of Pediatrics, St. Christopher's Hospital for Children, 3601 A Street, Philadelphia, PA 19134, USA; Drexel University College of Medicine, Philadelphia, PA, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Loscalzo
authors.affiliation: Department of Neonatology, St. Christopher's Hospital for Children, Philadelphia, PA, USA.
authors.forename: Panagiotis
authors.identifier: 0000-0002-7368-0436
authors.initials: P
authors.lastname: Kratimenos
authors.affiliation: Department of Pediatrics, St. Christopher's Hospital for Children, 3601 A Street, Philadelphia, PA 19134, USA.
authors.forename: Sabina
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Pediatrics, St. Christopher's Hospital for Children, 3601 A Street, Philadelphia, PA 19134, USA.
authors.forename: Evan
authors.initials: E
authors.lastname: Weiner
authors.affiliation: First Department of Pediatrics, University of Athens School of Medicine, Athens, Greece.
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Syriopoulou
authors.affiliation: First Department of Pediatrics, University of Athens School of Medicine, Athens, Greece.
authors.forename: Stamatios
authors.initials: S
authors.lastname: Theocharis
authors.affiliation: First Department of Pediatrics, University of Athens School of Medicine, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Chrousos