Kinetics of procalcitonin and C-reactive protein and the relationship to postoperative infection in young infants undergoing cardiovascular surgery

Jesse Davidson*, Suhong Tong, Amanda Hauck, D. Scott Lawson, Eduardo Da Cruz, Jon Kaufman

*Corresponding author for this work

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Background:The utility of procalcitonin (PCT) and C-reactive protein (CRP) as infectious biomarkers following infant cardiothoracic surgery is not well defined.Methods:We designed a prospective cohort study to evaluate PCT and CRP after infant cardiothoracic surgery. PCT and CRP were drawn preoperatively and 24/72 h postoperation or daily in delayed sternal closure patients. Presence of infection within 10 d of surgery, vasoactive-inotropic scores at 24 and 72 h, and length of intubation, intensive care unit stay, and hospital stay were documented.Results:PCT and CRP were elevated at 24 h. PCT then decreased while CRP increased in patients undergoing delayed sternal closure or cardiopulmonary bypass. In the delayed sternal closure group, PCT was significantly higher on postoperative days 2-5 in patients who ultimately developed infection. Higher PCT was independently associated with increased vasoactive-inotropic score at 72 h. CRP did not correlate with infection or postoperative support.Conclusion:PCT rises after cardiothoracic surgery in infants but decreases by 72 h while CRP remains elevated. Sternal closure may affect CRP but not PCT. PCT is independently associated with circulatory support requirements at 72 h postoperation and with development of infection. PCT may have greater utility as a biomarker in this population.

Original languageEnglish (US)
Pages (from-to)413-419
Number of pages7
JournalPediatric Research
Volume74
Issue number4
DOIs
StatePublished - Oct 1 2013

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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