Wednesday March 15, 2006
Regarding Procalcitonin
procalcitonin (PCT) has been claimed to be one of the most specific marker for sepsis/infection. It increases with high specificity in response to clinically relevant bacterial infections and sepsis. PCT has a fast kinetic and can be measured as soon as 3-4 hours after infection. Normal PCT value is less than 0.5 ng/ml and its level in sepsis is generally greater than 1-2 ng/ml and often between 10 and 1000 ng/ml. As the septic infection resolves, PCT reliably returns to low values with a half-life of 24 hours and here the actual value lies to follow the trend to see response to treatment. Another cost-effective advantage is to limit the days of antibiotics depending on resolving trend of PCT value.
In a recent study it was found that PCT values should be determine differently between medical and surgical patients . In surgical patients, the best diagnostic cutoff value was 9.70 ng/mL and in medical patients, the best diagnostic cutoff value was 1.00 ng/mL. It was concluded by authors that: Procalcitonin was a reliable early prognostic marker in medical but not in surgical patients with septic shock. (see reference # 2). Its real value still needs to be tested in a major trial as we have other inexpensive and generic tests available like WBC count, Lactic acid level, CRP etc.
Official web site procalcitonin.com
Previous Related Pearl: C-Reactive Protein (CRP) - marker of mortality in ICU ?
References: (click to get abstract - second popup overwrites first popup)
1. Diagnostic and prognostic value of procalcitonin in patients with septic shock. Critical Care Medicine. 32(5):1166-1169, May 2004.
2. Differential diagnostic value of procalcitonin in surgical and medical patients with septic shock. Critical Care Medicine. 34(1):102-107, January 2006.
