Montoya GC, Hernández LA, Villalobos SJA, Aguirre SJ, Franco GJ

Idioma: Español
Referencias bibliográficas: 21
Paginas: 211-217
Archivo PDF: 108.26 Kb.

RESUMEN

Introducción: La procalcitonina (PCT) en etapa temprana del choque séptico puede diferenciar entre una causa no infecciosa e infecciosa.
Objetivo: Determinar la utilidad de PCT como marcador diagnóstico temprano de choque séptico.
Metodología: Estudio prospectivo, longitudinal, observacional.
Resultados: Se incluyeron 108 pacientes con diagnóstico de choque. Se determinó PCT, velocidad de sedimentación globular (VSG), proteína C-reactiva (PCR) a su ingreso. Se observó que los pacientes con choque séptico presentaron aumento de PCT a 4 (3-5) vs 0 (0-0) choque no séptico (p ‹ 0.01); VSG de 20 (15-25) choque séptico vs choque no séptico de 9 (7-14) (p ‹ 0.01); PCR de 15 (10-19) vs 7 (4-10) respectivamente (p ‹ 0.01).
Conclusión: Se demostró que la PCT al ingreso de los pacientes en estado de choque es una de las mejores herramientas para diferenciar choque de causa infecciosa de otra no infecciosa.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Sierra R. C Reactive protein and procalcitonin as markers of infection, inflammatory response, and sepsis. Clinical Pulmonary Medicine 2007;14:314-320.

2. Becker KL, Nylen ES, White JC et al. Clinical review 167: procalcitonin and the calcitonin gene family of peptides inflammation, infection and sepsis: a jouney from calcitonin back to its precursors. J Clin Endocrinol Metab 2004; 89:1512-1525.

3. Meisner M. Pathobiochemistry and clinical use of procalcitonin. Clin Chim Acta 2002;323:17-29.

4. Uzzan B, Procalcitonin as a diagnostic test for sepsis in critically adults and after surgery or trauma: A systemic review and meta-analysis. Crit Care Med 2006;34:117-124.

5. Jensen JU, Heslet L. Procalcitonin increase in early identification of critically ill patient at high risk of mortality. Crit Care Med 2006;36:122-132.

6. Balc C, SurgertekinH, Gurses E, Surgertekin U. Kaptanoglu B. Usefulness of procalcitonin for diagnosis of sepsis in the intensive care unit. Crit Care 2003;7(1):85-90.

7. Becker KL. Procalcitonin assay in systemic inflammation, infection, and sepsis: clinical utility and limitations. Crit Care Med 2008;36:315-333.

8. Tamg BMP, Eslick GD. Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systemic review and meta-analysis. Lancet Infect Dis 2007;7:210-217.

9. Huang DT, Weisfeld LA. Risk prediction with procalcitonin and clinical rules in community acquired Pneumonia. Annals of Emergency Medicine 2008;52:1117-1132.

10. Martin GS, Maninno DM, Eaton S et al. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003;348:1546-1554.

11. Bone RC, Balk RA, Cerra FB. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 1992;101:1644.

12. Levy MM, Fink MP, Marshall JC et al. 001 SCCM/ESICM/ACCP/ATS/SIS international Sepsis Definitions conference. Crit Care Med 2003;31:1250-1256.

13. Assicot M, Gendrel D et al. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet 1993;341:515-532.

14. Cohen J, Brun-Buisson C, Torres A, Jorgensen J. Diagnosis of infection in sepsis: An evidence-based review. Crit Care Med 2004;32:S466-S494.

15. Ugarte H, Silva E, Mercan D, De Mendoza A, Vicent JL. Procalcitonin used as a marker of infection in the intensive care unit. Crit Care Med 999;27:498-504.

16. Ruokonen E, Ilkka L, Niskanen M, Takala J. Procalcitonin and neopterin as indicators of infection in critically ill patients. Acta Anaesthesiol Scand 2002;46:398-404.

17. Selberg O, Hecker H, Martin M, Klos A, Bautsch W, Köhl J. Discrimination of sepsis and systemic inflammatory response syndrome by determination of circulating plasma concentrations of procalcitonin, protein complement 3a, and interleukin-6. Crit Care Med 2000;28:2793-2798.

18. Harbarth S, Holeckova K, Froidevaux C, Pittet Didie, Ricou B et al. Diagnostic value of procalcitonin, Interleukin-6, and Interleukin-8 in critically ill patients admitted with suspected sepsis. Am J Respir Crit Care Med 2001;164: 396-402.

19. Tugrul S, Esen F, Celebi S, Ozcan PE, Akinci O, Cakar N et al. Reliability of procalcitonin as a severity marker in critically ill patients with inflammatory response. Anaesth Intensive Care 2002;30:747-754.

20. Balci C, Sungurtekin H, Gürses E, Sungurtekin U, Kaptanoglu B. Usefulness of procalcitonin for diagnosis of sepsis in the intensive care unit. Critical Care 2003;7:85-90.

21. Bochud PY, Boten M, Marchetti O, Calandra T. Antimicrobial therapy for patients with severe sepsis and septic shock: An evidence-based review. Crit Care Med 2004;32:S495-S512.