Los Arcos Marta, Rey Corsino, Concha Andrés, Medina Alberto, Prieto Belen
Paediatric Intensive Care Unit, Department of Paediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain.
BMC Pediatr. 2008 Apr 30;8:18. doi: 10.1186/1471-2431-8-18.
Procalcitonin (PCT) and C reactive protein (CRP) have been used as infection parameters. PCT increase correlates with the infection's severity, course, and mortality. Post-cardiocirculatory arrest syndrome may be related to an early systemic inflammatory response, and may possibly be associated with an endotoxin tolerance. Our objective was to report the time profile of PCT and CRP levels after paediatric cardiac arrest and to assess if they could be use as markers of immediate survival.
A retrospective observational study set in an eight-bed PICU of a university hospital was performed during a period of two years. Eleven children younger than 14 years were admitted in the PICU after a cardiac arrest. PCT and CRP plasma concentrations were measured within the first 12 and 24 hours of admission.
In survivors, PCT values increased 12 hours after cardiac arrest without further increase between 12 and 24 hours. In non survivors, PCT values increased 12 hours after cardiac arrest with further increase between 12 and 24 hours. Median PCT values (range) at 24 hours after cardiac arrest were 22.7 ng/mL (0.2 - 41.0) in survivors vs. 205.5 ng/mL (116.6 - 600.0) in non survivors (p < 0.05). CRP levels were elevated in all patients, survivors and non-survivors, at 12 and 24 hours without differences between both groups.
Measurement of PCT during the first 24 hours after paediatric cardiac arrest could serve as marker of mortality.
降钙素原（PCT）和C反应蛋白（CRP）已被用作感染指标。PCT升高与感染的严重程度、病程及死亡率相关。心搏骤停后综合征可能与早期全身炎症反应有关，且可能与内毒素耐受有关。我们的目的是报告小儿心脏骤停后PCT和CRP水平随时间的变化情况，并评估它们是否可作为即刻生存的标志物。
在一所大学医院有8张床位的儿科重症监护病房（PICU）进行了一项为期两年的回顾性观察研究。11名14岁以下儿童在心脏骤停后被收入PICU。在入院后的前12小时和24小时内测定血浆PCT和CRP浓度。
存活者在心脏骤停后12小时PCT值升高，在12至24小时之间无进一步升高。非存活者在心脏骤停后12小时PCT值升高，在12至24小时之间进一步升高。心脏骤停后24小时存活者的PCT值中位数（范围）为22.7 ng/mL（0.2 - 41.0），而非存活者为205.5 ng/mL（116.6 - 600.0）（p < 0.05）。所有患者（存活者和非存活者）在12小时和24小时时CRP水平均升高，两组之间无差异。
小儿心脏骤停后24小时内测定PCT可作为死亡率的标志物。
