A study aimed at identifying the level of procalcitonin in the blood for the diagnosis of sepsis, septic complications, severe bacterial infections and purulent-inflammatory processes.
Procalcitonin is a prohormone, a precursor of the hormone calcitonin, which is involved in calcium metabolism and maintains a constant level in the blood. The polypeptide procalcitonin consists of 116 amino acids and is synthesized by the C-cells of the thyroid gland. Normally, its amount is extremely small and is found in the blood in trace amounts. The advantage of determining procalcitonin is that its synthesis in the systemic inflammatory response reaches high levels earlier than other acute phase proteins. The syndrome of a systemic inflammatory response or reaction is characterized by a change in body temperature of more than 38 ° C or less than 36 ° C, an increase in the heart rate of more than 90 beats per minute, an increase in the respiratory rate of more than 20 per minute, a change in the number of leukocytes in the blood (less than 4 × 109 or more 12 × 109 cells per liter of blood) or by shifting the leukocyte count to the left.
When is the study scheduled?
If you suspect sepsis, septic shock, the development of a systemic inflammatory response syndrome, multiple organ failure syndrome;
With symptoms of severe infectious, purulent-inflammatory processes of various localization;
If you suspect the development of a generalized bacterial infection in adults, children and newborns;
If you suspect the development of infectious complications in patients in the conditions of surgical and intensive care units;
If you suspect the attachment of a secondary bacterial infection in patients with viral infections, allergic, autoimmune diseases;
After extensive surgical interventions, operations in conditions of artificial circulation, multiple injuries, with severe burns, acute graft rejection, subarachnoid hemorrhage, with chronic heart failure;
When prescribing and monitoring specific antibiotic therapy.
How to properly prepare for the study?
Eliminate alcohol from the diet for 24 hours before the study.
Children under the age of 1 year should not eat for 30-40 minutes before the study.
Children aged 1 to 5 years should not eat for 2-3 hours before the examination.
Do not eat for 8 hours before the study, you can drink clean non-carbonated water.
Eliminate physical and emotional stress within 30 minutes before the study.
Do not smoke for 30 minutes prior to examination.
PCT levels clearly correlate with the severity of the inflammatory process:
PCT <0.5 ng / ml - low risk of severe sepsis and / or septic shock.
PCT from 0.5 to 2 ng / ml - moderate systemic inflammatory response syndrome (SIRS) - "gray zone". It is impossible to diagnose sepsis with certainty; it is recommended to repeat the measurement within 6-24 hours.
PCT> 2 ng / ml - severe systemic inflammatory response syndrome (SIRS), high risk of severe sepsis and / or septic shock (sensitivity 85%, specificity 93%).
PCT 10 ng / ml and higher - severe systemic inflammatory response syndrome (SIRS) - almost always due to severe bacterial sepsis or septic shock. These PCT levels are often associated with multiple organ dysfunction syndrome (MDS) and indicate a high risk of death.
When interpreting the results of the study, it is necessary to take into account the clinical picture of the disease, the presence of concomitant diseases and complications, the use of antibiotic therapy.
In newborns, the level of procalcitonin increases in the first 12 hours after birth, reaching a maximum within 24-36 hours, decreasing to normal levels by 4-5 days after birth. In this regard, it is recommended to repeat the study after 24 hours to exclude generalized bacterial infection, neonatal sepsis.
The use of drugs, in particular immunosuppressants, which increase the synthesis of proinflammatory cytokines, can increase the concentration of procalcitonin.
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