Granulocyte elastase compared to C-reactive protein for early diagnosis of septicemia in critically ill patients.

Plasma levels of granulocyte elastase and C-reactive protein were measured 0, 12, 24 and 48 h after suspicion of septicemia in 64 critically ill patients. Initial elastase levels were higher in 16 bacteremic patients (mean 773 micrograms/l) than in 48 non-bacteremic patients (mean 341 micrograms/l, p less than 0.01), whereas C-reactive protein levels were similar in both groups. At a level of 100% sensitivity for the early detection of septicemia, increased elastase was less than 50% specific, indicating limited diagnostic usefulness in this setting.