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Diagnosing infection after infant open heart surgery: role of procalcitonin

机译:婴儿露天心脏手术后诊断感染:procalcitonin的作用

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Background Diagnosing infection in infants after cardiac surgery with cardiopulmonary bypass remains challenging. We aimed to determine whether procalcitonin discriminates post-cardiopulmonary bypass systemic inflammatory response syndrome from bacterial infection in infants better than C-reactive protein and leukocyte count. Method One hundred and eight infants underwent cardiac surgery with cardiopulmonary bypass. Leukocyte count, C-reactive protein, and procalcitonin were measured on arrival in the intensive care unit as baseline, and repeated on postoperative day 3. Bacterial infection was defined as proven infection with a positive blood or sputum culture. Results Twenty-four infants had proven bacterial infection. Baseline leukocyte counts and C-reactive protein levels did not differ significantly between the 2 groups. On postoperative day 3, C-reactive protein (62 vs. 38.5?mg·L~(?1), p ?=?0.01) and procalcitonin levels (6.58 vs. 0.41?ng·mL~(?1), p ?
机译:背景诊断在婴儿的感染在心脏手术与心肺旁路后仍然具有挑战性。我们旨在确定ProCalcitonin是否鉴别婴儿细菌感染后患有后心肺后的全身炎症症综合征,比C反应蛋白和白细胞计数更好。方法一百八八婴儿随后心脏手术与心肺手术旁路。白细胞计数,C-反应蛋白和ProCalcitonin在到达重症监护病房作为基线时测量,并在术后第3天重复。细菌感染被定义为具有阳性血液或痰培养的经过验证的感染。结果二十四个婴儿已被证明是细菌感染。基线白细胞计数和C反应蛋白水平在2组之间没有显着差异。在术后第3天,C-反应蛋白(62〜38.5×mg·l〜(α1),p?= 0.01)和procalcitonin水平(6.58 vs.0.41?ng·ml〜(?1),p?细菌感染患者患者较高<?0.01)。两组之间的白细胞计数没有显着差异(P?= 0.94)。用于白细胞计数,C-反应蛋白和ProCalcitonin的接收器操作曲线下的区域为0.49(p?= 0.94),0.67(p?= 0.01),分别为0.87(p?<0.0010)。 ProCalcitonin的最佳截止值为2.5?ng·ml〜(α1)(敏感性75%,特异性88%)。结论在婴幼儿接受心肺手术的心肺手术中,ProCalcitonin判断基于C-反应蛋白和白细胞计数的心肺后全身炎症反应综合征的细菌感染。

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