Procalcitonin as a marker of bacterial infection in the emergency department: an observational study.

Abstract:

INTRODUCTION:Procalcitonin (PCT) has been proposed as a marker of infection in critically ill patients; its level is related to the severity of infection. We evaluated the value of PCT as a marker of bacterial infection for emergency department patients. METHODS:This prospective observational study consecutively enrolled 120 adult atraumatic patients admitted through the emergency department of a 3000-bed tertiary university hospital in May 2001. Fifty-eight patients were infected and 49 patients were not infected. The white blood cell counts, the serum C-reactive protein (CRP) level (mg/l), and the PCT level (ng/ml) were compared between the infected and noninfected groups of patients. RESULTS:A white blood cell count >12,000/mm3 or <4000/mm3 was present in 36.2% of the infected patients and in 18.4% of the noninfected patients. The best cut-off serum levels for PCT and CRP, identified using the Youden's Index, were 0.6 ng/ml and 60 mg/l, respectively. Compared with CRP, PCT had a comparable sensitivity (69.5% versus 67.2%), a lower specificity (64.6% versus 93.9%), and a lower area under the receiver operating characteristic curve (0.689 versus 0.879). PCT levels, but not CRP levels, were significantly higher in bacteremic and septic shock patients. Multivariate logistic regression identified that a PCT level >/= 2.6 ng/ml was independently associated with the development of septic shock (odds ratio, 38.3; 95% confidence interval, 5.6-263.5; P < 0.001). CONCLUSIONS:PCT is not a better marker of bacterial infection than CRP for adult emergency department patients, but it is a useful marker of the severity of infection.

journal_name

Crit Care

authors

Chan YL,Tseng CP,Tsay PK,Chang SS,Chiu TF,Chen JC

doi

10.1186/cc2396

keywords:

subject

Has Abstract

pub_date

2004-02-01 00:00:00

pages

R12-20

issue

1

eissn

1364-8535

issn

1466-609X

pii

cc2396

journal_volume

8

pub_type

杂志文章
  • Endothelial progenitor cells (EPC) in sepsis with acute renal dysfunction (ARD).

    abstract:INTRODUCTION:Sepsis is characterized by systemic microvascular dysfunction. Endothelial progenitor cells (EPCs) are critically involved in maintaining vascular homeostasis under both physiological and pathological conditions. The aim of the present study was to analyze the endothelial progenitor cell system in patients...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc10100

    authors: Patschan SA,Patschan D,Temme J,Korsten P,Wessels JT,Koziolek M,Henze E,Müller GA

    更新日期:2011-01-01 00:00:00

  • Clinical review: Prognostic value of magnetic resonance imaging in acute brain injury and coma.

    abstract::Progress in management of critically ill neurological patients has led to improved survival rates. However, severe residual neurological impairment, such as persistent coma, occurs in some survivors. This raises concerns about whether it is ethically appropriate to apply aggressive care routinely, which is also associ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc6107

    authors: Weiss N,Galanaud D,Carpentier A,Naccache L,Puybasset L

    更新日期:2007-01-01 00:00:00

  • Thrombocytopenia in critically ill surgical patients: a case-control study evaluating attributable mortality and transfusion requirements.

    abstract::BACKGROUND: That thrombocytopenia results in increased mortality or transfusion requirements has not been confirmed by previous studies. We performed a case-control study in which 36 patients who developed severe thrombocytopenia of less than 50x109 platelets/l were carefully matched for the severity of underlying dis...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc369

    authors: Stephan F,Montblanc Jd,Cheffi A,Bonnet F

    更新日期:1999-01-01 00:00:00

  • Estimation of the diaphragm neuromuscular efficiency index in mechanically ventilated critically ill patients.

    abstract:BACKGROUND:Diaphragm dysfunction develops frequently in ventilated intensive care unit (ICU) patients. Both disuse atrophy (ventilator over-assist) and high respiratory muscle effort (ventilator under-assist) seem to be involved. A strong rationale exists to monitor diaphragm effort and titrate support to maintain resp...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-018-2172-0

    authors: Jansen D,Jonkman AH,Roesthuis L,Gadgil S,van der Hoeven JG,Scheffer GJ,Girbes A,Doorduin J,Sinderby CS,Heunks LMA

    更新日期:2018-09-27 00:00:00

  • Bench-to-bedside review: circulating microparticles--a new player in sepsis?

    abstract::In sepsis, inflammation and thrombosis are both the cause and the result of interactions between circulating (for example, leukocytes and platelets), endothelial and smooth muscle cells. Microparticles are proinflammatory and procoagulant fragments originating from plasma membrane generated after cellular activation a...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc9231

    authors: Meziani F,Delabranche X,Asfar P,Toti F

    更新日期:2010-01-01 00:00:00

  • Cell-free DNA and outcome in sepsis.

    abstract::Severe sepsis can be a catastrophic condition that is often associated with poor outcomes. The early diagnosis and management of the condition are vital in order to improve the chances of survival. However, owing to the syndromal nature of its definition and the lack of a biomarker able to accurately confirm the condi...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc11508

    authors: Rhodes A,Cecconi M

    更新日期:2012-11-08 00:00:00

  • Pharmacokinetic variability and exposures of fluconazole, anidulafungin, and caspofungin in intensive care unit patients: Data from multinational Defining Antibiotic Levels in Intensive care unit (DALI) patients Study.

    abstract:INTRODUCTION:The objective of the study was to describe the pharmacokinetics (PK) of fluconazole, anidulafungin, and caspofungin in critically ill patients and to compare with previously published data. We also sought to determine whether contemporary fluconazole doses achieved PK/pharmacodynamic (PD; PK/PD) targets in...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-0758-3

    authors: Sinnollareddy MG,Roberts JA,Lipman J,Akova M,Bassetti M,De Waele JJ,Kaukonen KM,Koulenti D,Martin C,Montravers P,Rello J,Rhodes A,Starr T,Wallis SC,Dimopoulos G,DALI Study authors.

    更新日期:2015-02-04 00:00:00

  • The race against the "septic shark".

    abstract::Great white sharks are responsible for about 10 cases of death annually worldwide, as compared with millions of deaths caused by sepsis. However, the basic principles of avoiding shark attacks and fighting sepsis seem to be similar: avoidance, attention, and speed, if necessary. The present review discusses the curren...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc14729

    authors: Westphal M,Kampmeier T

    更新日期:2015-01-01 00:00:00

  • Succinylcholine versus rocuronium for rapid sequence intubation in intensive care: a prospective, randomized controlled trial.

    abstract:INTRODUCTION:Succinylcholine and rocuronium are widely used to facilitate rapid sequence induction (RSI) intubation in intensive care. Concerns relate to the side effects of succinylcholine and to slower onset and inferior intubation conditions associated with rocuronium. So far, succinylcholine and rocuronium have not...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc10367

    authors: Marsch SC,Steiner L,Bucher E,Pargger H,Schumann M,Aebi T,Hunziker PR,Siegemund M

    更新日期:2011-08-16 00:00:00

  • Targeting the programmed cell death 1: programmed cell death ligand 1 pathway reverses T cell exhaustion in patients with sepsis.

    abstract:INTRODUCTION:A major pathophysiologic mechanism in sepsis is impaired host immunity which results in failure to eradicate invading pathogens and increased susceptibility to secondary infections. Although many immunosuppressive mechanisms exist, increased expression of the inhibitory receptor programmed cell death 1 (PD...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13176

    authors: Chang K,Svabek C,Vazquez-Guillamet C,Sato B,Rasche D,Wilson S,Robbins P,Ulbrandt N,Suzich J,Green J,Patera AC,Blair W,Krishnan S,Hotchkiss R

    更新日期:2014-01-04 00:00:00

  • European legislation impedes critical care research and fails to protect patients' rights.

    abstract::The European Clinical Trials Directive requires an informed consent from the patient or a proxy in drug trials. Although informed consent is a valuable tool to protect patients' rights in clinical trials, this requirement largely impedes research in critical care settings, and if pursued in this context, it does not p...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc10113

    authors: Berg RM,Møller K,Rossel PJ

    更新日期:2011-01-01 00:00:00

  • Microcirculatory perfusion disturbances following cardiac surgery with cardiopulmonary bypass are associated with in vitro endothelial hyperpermeability and increased angiopoietin-2 levels.

    abstract:BACKGROUND:Endothelial hyperpermeability following cardiopulmonary bypass (CPB) contributes to microcirculatory perfusion disturbances and postoperative complications after cardiac surgery. We investigated the postoperative course of renal and pulmonary endothelial barrier function and the association with microcircula...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-019-2418-5

    authors: Dekker NAM,van Leeuwen ALI,van Strien WWJ,Majolée J,Szulcek R,Vonk ABA,Hordijk PL,Boer C,van den Brom CE

    更新日期:2019-04-11 00:00:00

  • Inhaled nitric oxide and the risk of renal dysfunction in patients with acute respiratory distress syndrome: a propensity-matched cohort study.

    abstract:BACKGROUND:Inhaled nitric oxide (iNO) is a rescue therapy for severe hypoxemia in patients with acute respiratory distress syndrome (ARDS). Pooled data from clinical trials have signaled a renal safety warning for iNO therapy, but the significance of these findings in daily clinical practice is unclear. We used primary...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1566-0

    authors: Ruan SY,Wu HY,Lin HH,Wu HD,Yu CJ,Lai MS

    更新日期:2016-11-30 00:00:00

  • Effect of the molecular adsorbent recirculating system and Prometheus devices on systemic haemodynamics and vasoactive agents in patients with acute-on-chronic alcoholic liver failure.

    abstract:INTRODUCTION:Patients with acute-on-chronic liver failure show an aggravated hyperdynamic circulation. We evaluated, in a controlled manner, potential changes in systemic haemodynamics induced by the molecular adsorbent recirculating system (MARS) and the Prometheus system liver detoxification devices in a group of pat...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc4985

    authors: Laleman W,Wilmer A,Evenepoel P,Elst IV,Zeegers M,Zaman Z,Verslype C,Fevery J,Nevens F

    更新日期:2006-01-01 00:00:00

  • Impact of intensive care unit admission during morning bedside rounds and mortality: a multi-center retrospective cohort study.

    abstract:INTRODUCTION:Recent data have suggested that patient admission during intensive care unit (ICU) morning bedside rounds is associated with less favorable outcome. We undertook the present study to explore the association between morning round-time ICU admissions and hospital mortality in a large Canadian health region. ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc11329

    authors: de Souza IA,Karvellas CJ,Gibney RT,Bagshaw SM

    更新日期:2012-05-03 00:00:00

  • Percutaneous dilatation tracheostomy: which technique is the best for the critically ill patient, and how can we gather further scientific evidence?

    abstract::Percutaneous dilatation tracheostomy in the intensive care setting presents an increasingly important concept for establishing a large-bore tracheal airway with minimal surgical intervention. Over the last years, different technical solutions have been studied to assess their respective risks and benefits to determine...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc2968

    authors: Brambrink A

    更新日期:2004-10-01 00:00:00

  • In-hospital percentage BNP reduction is highly predictive for adverse events in patients admitted for acute heart failure: the Italian RED Study.

    abstract:INTRODUCTION:Our aim was to evaluate the role of B-type natriuretic peptide (BNP) percentage variations at 24 hours and at discharge compared to its value at admission in order to demonstrate its predictive value for outcomes in patients with acute decompensated heart failure (ADHF). METHODS:This was a multicenter Ita...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc9067

    authors: Di Somma S,Magrini L,Pittoni V,Marino R,Mastrantuono A,Ferri E,Ballarino P,Semplicini A,Bertazzoni G,Carpinteri G,Mulè P,Pazzaglia M,Shah K,Maisel A,Clopton P

    更新日期:2010-01-01 00:00:00

  • Dexmedetomidine sedation reduces atrial fibrillation after cardiac surgery compared to propofol: a randomized controlled trial.

    abstract:BACKGROUND:Atrial fibrillation occurs frequently in patients following cardiac surgery and can be a cause of increased morbidity and mortality. The use of dexmedetomidine to prevent atrial fibrillation is unclear. The present study was designed to evaluate the effect of dexmedetomidine sedation on the incidence of atri...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1480-5

    authors: Liu X,Zhang K,Wang W,Xie G,Fang X

    更新日期:2016-09-21 00:00:00

  • Delirium prediction in the intensive care unit: comparison of two delirium prediction models.

    abstract:BACKGROUND:Accurate prediction of delirium in the intensive care unit (ICU) may facilitate efficient use of early preventive strategies and stratification of ICU patients by delirium risk in clinical research, but the optimal delirium prediction model to use is unclear. We compared the predictive performance and user c...

    journal_title:Critical care (London, England)

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1186/s13054-018-2037-6

    authors: Wassenaar A,Schoonhoven L,Devlin JW,van Haren FMP,Slooter AJC,Jorens PG,van der Jagt M,Simons KS,Egerod I,Burry LD,Beishuizen A,Matos J,Donders ART,Pickkers P,van den Boogaard M

    更新日期:2018-05-05 00:00:00

  • Does anesthetic provide similar neuroprotection to therapeutic hypothermia after cardiac arrest?

    abstract::In the previous issue of Critical Care, Meybohm and colleagues provide evidence to support hypothermia as a kind of therapeutic option for patients suffering cardiac arrest. Although anesthetics had been used to induce hypothermia, sevoflurane post-conditioning fails to confer additional anti-inflammatory effects afte...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc8923

    authors: Zhang H

    更新日期:2010-01-01 00:00:00

  • Prognostic value of platelet-to-lymphocyte ratios among critically ill patients with acute kidney injury.

    abstract:BACKGROUND:Inflammation plays an important role in the initiation and progression of acute kidney injury (AKI). However, evidence regarding the prognostic effect of the platelet-to-lymphocyte ratio (PLR), a novel systemic inflammation marker, among patients with AKI is scarce. In this study, we investigated the value o...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-017-1821-z

    authors: Zheng CF,Liu WY,Zeng FF,Zheng MH,Shi HY,Zhou Y,Pan JY

    更新日期:2017-09-08 00:00:00

  • Success and complications by team composition for prehospital paediatric intubation: a systematic review and meta-analysis.

    abstract:BACKGROUND:Clinical team composition for prehospital paediatric intubation may affect success and complication rates. We performed a systematic review and meta-analysis to determine the success and complication rates by type of clinical team. METHODS:We searched MEDLINE, EMBASE, and CINAHL for interventional and obser...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,meta分析

    doi:10.1186/s13054-020-02865-y

    authors: Garner AA,Bennett N,Weatherall A,Lee A

    更新日期:2020-04-15 00:00:00

  • Endotoxemia and mortality prediction in ICU and other settings: underlying risk and co-detection of gram negative bacteremia are confounders.

    abstract:INTRODUCTION:The interdependence between endotoxemia, gram negative (GN) bacteremia and mortality has been extensively studied. Underlying patient risk and GN bacteremia types are possible confounders of the relationship. METHODS:Published studies with ≥ 10 patients in either ICU or non-ICU settings, endotoxemia detec...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc11462

    authors: Hurley JC,Guidet B,Offenstadt G,Maury E

    更新日期:2012-08-07 00:00:00

  • Bench-to-bedside review: Bacterial virulence and subversion of host defences.

    abstract::Bacterial pathogens possess an array of specific mechanisms that confer virulence and the capacity to avoid host defence mechanisms. Mechanisms of virulence are often mediated by the subversion of normal aspects of host biology. In this way the pathogen modifies host function so as to promote the pathogen's survival o...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc7091

    authors: Webb SA,Kahler CM

    更新日期:2008-01-01 00:00:00

  • Persistent organ dysfunction plus death: a novel, composite outcome measure for critical care trials.

    abstract:INTRODUCTION:Due to resource limitations, few critical care interventions have been rigorously evaluated with adequately powered randomized clinical trials (RCTs). There is a need to improve the efficiency of RCTs in critical care so that more definitive high quality RCTs can be completed with the available resources. ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc10110

    authors: Heyland DK,Muscedere J,Drover J,Jiang X,Day AG,Canadian Critical Care Trials Group.

    更新日期:2011-01-01 00:00:00

  • The effect of glutamine infusion on the inflammatory response and HSP70 during human experimental endotoxaemia.

    abstract:INTRODUCTION:Glutamine supplementation has beneficial effects on morbidity and mortality in critically ill patients, possibly in part through an attenuation of the proinflammatory cytokine response and a stimulation of heat shock protein (HSP)70. We infused either alanine-glutamine or saline during endotoxin challenge ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc7696

    authors: Andreasen AS,Pedersen-Skovsgaard T,Mortensen OH,van Hall G,Moseley PL,Pedersen BK

    更新日期:2009-01-01 00:00:00

  • Central venous oxygenation: when physiology explains apparent discrepancies.

    abstract::Central venous oxygen saturation (ScvO2) >70% or mixed venous oxygen saturation (SvO2) >65% is recommended for both septic and non-septic patients. Although it is the task of experts to suggest clear and simple guidelines, there is a risk of reducing critical care to these simple recommendations. This article reviews ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-014-0579-9

    authors: Squara P

    更新日期:2014-11-10 00:00:00

  • Re-tooling critical care to become a better intensivist: something old and something new.

    abstract::Developments in recent years have placed powerful new tools of diagnosis, therapy, and communication at the disposal of medicine in general, and of critical care in particular. The art of healing requires not only technical proficiency, but also personal connection, multidisciplinary teamwork, and commitment to the ve...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc14721

    authors: Marini JJ

    更新日期:2015-01-01 00:00:00

  • Mechanical ventilation with high tidal volume induces inflammation in patients without lung disease.

    abstract:INTRODUCTION:Mechanical ventilation (MV) with high tidal volumes may induce or aggravate lung injury in critical ill patients. We compared the effects of a protective versus a conventional ventilatory strategy, on systemic and lung production of tumor necrosis factor-alpha (TNF-alpha) and interleukin-8 (IL-8) in patien...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc8919

    authors: Pinheiro de Oliveira R,Hetzel MP,dos Anjos Silva M,Dallegrave D,Friedman G

    更新日期:2010-01-01 00:00:00

  • Upregulation of the pro-apoptotic genes BID and FAS in septic shock patients.

    abstract:INTRODUCTION:Lymphocyte apoptosis has been suggested to play a central role in sepsis pathophysiology, and studies in animal models demonstrated that blocking this pathway improves outcome. However, no routine biomarkers of apoptosis are so far available in patients. Thus, the aim of our study was to assess the differe...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc9181

    authors: Turrel-Davin F,Guignant C,Lepape A,Mougin B,Monneret G,Venet F

    更新日期:2010-01-01 00:00:00