|Boeken U et al.|
The influence of extracorporeal circulation and inflammatory responses such as SIRS and sepsis on secretion of procalcitonin (PCT)
Journal of Clinical and Basic Cardiology 1999; 2 (2): 225-227
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Keywords: Bypass, C-reaktives Protein, procalcitonin, sepsis, SIRS, systemische Entzündungsreaktion, C-reactive protein, cardiopulmonary bypass, procalcitonin, sepsis, SIRS, systemic inflammatory response syndrome
The reasons for a systemic inflammatory response syndrom (SIRS) following extracorporeal circulation (ECC) are not yet fully understood. PCT shall be a parameter to distinguish between bacterial infections and a non-bacterial systemic inflammation. We investigated the influence of cardiopulmonary bypass (CPB), systemic inflammation and septic conditions on the PCT-values. We analyzed 30 patients undergoing coronary artery bypass grafting (CABG). Blood samples for PCT-measurement were taken 6 times perioperatively. 21 of these patients did not develop postoperative complications (group A), while 9 patients suffered from a ?post-perfusion-syndrome? (PPS) for at most 36 hours (group B). Furthermore blood samples were taken from 30 preoperatively comparable patients who suffered from bacterial infection (n = 15) (group C) or a SIRS (n = 15) (group D) after ECC; in this group PCT was determined daily after the onset of inflammation. There was no significant PCT-elevation in groups A and B at all 6 times of measurement. In sepsis patients a significant elevation of PCT with the peak level of 19.7 ± 6.2 ng/ml on the second day after diagnosis was seen, compared to 0.7 ± 0.4 ng/ml in SIRS patients. In this study it was demonstrated that ECC and a temporarily limited PPS did not have any influence on the secretion of PCT. A systemic bacterial infection caused a significant increase of PCT, whereas PCT-values remained normal in case of a SIRS. So it seems to be possible to distinguish between a SIRS and a bacterial proven sepsis by means of PCT. J Clin Basic Cardiol 1999; 2: 225-7.