title: Procalcitonin Dynamics After Long-Term Ventricular Assist Device Implantation.
abstract: BACKGROUND
  Infectious complications (IC) are one of the main causes of worsening prognosis after long-term ventricular assist device (LVAD) implantation. Procalcitonin (PCT) is widely used for diagnosis of a bacterial infection. The objective of this study was to assess PCT dynamics after LVAD surgery and their relationship to the infectious complications.
  
  
  METHODS
  A total of 25 consecutive patients indicated for LVAD implantation as a bridge to heart transplant were included. Procalcitonin levels were prospectively assessed before surgery and during the postoperative period (day 1, 2, 14 and 30). Values were compared according to the presence of IC.
  
  
  RESULTS
  Procalcitonin levels were low before surgery, raised significantly within 1st and 2nd day after operation and decreased in the 14th and 30th days back to the baseline. There was no significant difference in PCT values between patients with or without IC as well as with or without right ventricle assist device (RVAD). Acute renal failure (ARF) increased PCT significantly only 14 days after LVAD implantation. In patients with ARF and/or RVAD we observed significantly higher PCT values in the 2nd, 14thand 30thday after operation. In subjects with IC and/or ARF and/or RVAD we also observed significantly elevated PCT concentrations 2 and 14 days after surgery.
  
  
  CONCLUSIONS
  Our data show that the ability of PCT to detect IC in patients after LVAD implantation is limited and its concentrations more likely correlate with postoperative complications in general.
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Kettner
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 3(rd) Faculty of Medicine, Charles University in Prague, 3 Prague, Czech Republic. Electronic address: martin.holek@ikem.cz.
authors.forename: Martin
authors.initials: M
authors.lastname: Holek
authors.affiliation: Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 3(rd) Faculty of Medicine, Charles University in Prague, 3 Prague, Czech Republic.
authors.forename: Janka
authors.initials: J
authors.lastname: Franekova
authors.affiliation: Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 3(rd) Faculty of Medicine, Charles University in Prague, 3 Prague, Czech Republic.
authors.forename: Antonin
authors.initials: A
authors.lastname: Jabor
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Marian
authors.initials: M
authors.lastname: Pindak
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Hynek
authors.initials: H
authors.lastname: Riha
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Kautzner
authors.affiliation: Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Pirk
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000097:blood / Q000209:etiology; D002116:Calcitonin / Q000097:blood*; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood; D011184:Postoperative Period
chemical_list: D002116:Calcitonin
keywords: Heart failure; Infection; Mechanical circulatory support; Procalcitonin; Systemic inflammatory response syndrome; Ventricular assist device