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The Utility of Serum Procalcitonin Levels in the Management of Systemic Inflammatory Response Syndrome in the Emergency Department
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Kyung Hye Park, Kang Hyun Lee, Kyoung Chul Cha, Hyun Kim, Sung Oh Hwang
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Korean J Crit Care Med. 2012;27(1):10-15.
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DOI: https://doi.org/10.4266/kjccm.2012.27.1.10
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 Abstract
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- BACKGROUND
The aim of this study was to investigate whether obtaining serum procalcitonin (PCT) levels in patients with systemic inflammatory response syndrome (SIRS) helps the differential diagnosis between sepsis and non-sepsis and predicts disease severity in the emergency department (ED).
METHODS
This prospective study enrolled 132 consecutive adult patients with SIRS who visited the ED. Serum C-reactive protein (CRP) levels and serum PCT levels were compared between sepsis and non-sepsis groups upon ED admission. Sequential Organ Failure Assessment (SOFA), Multiple Organ Dysfunction Score (MODS), and Acute Physiology and Chronic Health Evaluation (APACHE) III scores were calculated, and their correlations with CRP and PCT levels were evaluated. The PCT and CRP levels were assessed to predict sepsis in terms of comparing receiver operating characteristic (ROC) curves.
RESULTS
Eighty patients were included in the sepsis group.
The levels of PCT and CRP in the sepsis group were significantly higher. In the sepsis group, the initial serum PCT correlated with the SOFA and MODS scores, and this also correlated in the non-sepsis group, but CRP did not. No differences were found when the PCT and CRP ROCs were compared.
CONCLUSIONS
Correlation between PCT and severity in the non-sepsis group is considered to be clinically meaningless because of low levels. Additionally, PCT levels had similar diagnostic value for sepsis as CRP levels. PCT is recommended for prediction of severity in sepsis patients in ED, but not for differential diagnosis between sepsis and non-sepsis.
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The Efficacy of Early Goal-directed Therapy in Septic Shock Patients in the Emergency Department: Severe Sepsis Campaign
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Hyung Jin Shin, Kang Hyun Lee, Sung Oh Hwang, Hyun Kim, Tae Yong Shin, Sang Chul Kim
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Korean J Crit Care Med. 2010;25(2):61-70.
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DOI: https://doi.org/10.4266/kjccm.2010.25.2.61
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Abstract
PDF
- BACKGROUND
Early goal-directed therapy (EGDT) has been used for patients with severe sepsis and septic shock in the emergency department (ED). In 2003, international management guidelines for severe sepsis and septic shock were developed under the auspices of the Surviving Sepsis Campaign (SSC); however, EGDT based on the SSC was not fully evaluated in the ED. The purpose of this study was to evaluate the efficacy of EGDT based on the SSC in the ED in Korea.
METHODS
We randomly assigned patients who arrived at our ED in septic shock to receive EGDT before admission to the intensive care unit between May 2007 and July 2007, and we retrospectively assigned patients in septic shock to receive standard therapy between May 2006 and July 2006. The in-hospital mortality for 24 hours and 28 days, the MODS, SAPS II, and APACHE II scores were obtained and compared between the study groups.
RESULTS
Of the 60 enrolled patients, 30 were assigned to EGDT and 30 were assigned to standard therapy. There was no significant difference between the groups with respect to the baseline characteristics. In-hospital mortality at 28 days was 13% in the group assigned to EGDT as compared to 40% in the group assigned to standard therapy (p = 0.020) and in-hospital mortality at 24 hours was 0% and 13%, respectively (p = 0.038).
CONCLUSIONS
EGDT provides significant benefits with respect to outcome in patients in septic shock.
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Citations
Citations to this article as recorded by  - Early goal-directed resuscitation for patients with severe sepsis and septic shock: a meta-analysis and trial sequential analysis
Li-bing Jiang, Mao Zhang, Shou-yin Jiang, Yue-feng MA
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2016;[Epub] CrossRef - The Prognostic Factors of Pneumonia with Septic Shock in Patients Presenting to the Emergency Department
Jong Won Kim, Jin Joo Kim, Hyuk Jun Yang, Yong Su Lim, Jin Seong Cho, In Cheol Hwang, Sang Hyun Han
The Korean Journal of Critical Care Medicine.2015; 30(4): 258. CrossRef - Implementing a Sepsis Resuscitation Bundle Improved Clinical Outcome: A Before-and-After Study
Jeongmin Kim, Sungwon Na, Young Chul Yoo, Shin Ok Koh
Korean Journal of Critical Care Medicine.2014; 29(4): 250. CrossRef - A Case of Purulent Pericarditis Complicated byKlebsiella pneumoniaeSepsis - A Case Report -
Byeong-Ho Jeong, Seungmin Chung, Hee Jin Kwon, Kyeongman Jeon
Korean Journal of Critical Care Medicine.2013; 28(1): 51. CrossRef
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