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Early identification of infectious complications in lung transplant recipients using procalcitonin
Author(s) -
Suberviola B.,
CastellanosOrtega A.,
Ballesteros M.A.,
Zurbano F.,
Naranjo S.,
Miñambres E.
Publication year - 2012
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2012.00780.x
Subject(s) - procalcitonin , medicine , intensive care unit , receiver operating characteristic , lung transplantation , prospective cohort study , observational study , lung , transplantation , gastroenterology , intensive care medicine , sepsis
Objectives The purpose of this study was to determine how sequential measurements of procalcitonin ( PCT ) could improve the diagnosis of early infectious complications after lung transplantation, and to compare this molecule with other commonly used markers (serum C‐reactive protein [ CRP ] and leukocyte count). Methods Prospective observational study in a 34‐bed university hospital intensive care unit ( ICU ). All lung transplant ( LT ) recipients between J anuary and N ovember 2010 were included. Biomarkers were measured just before surgery, on ICU admission, and daily on postoperative days 2, 3, 4, and 7. Results A total of 25 patients were included. Those patients with infectious complications presented with significantly higher levels of PCT as early as the first day after transplantation and during subsequent days. The area under receiver operating characteristic curve for PCT as a predictor of infection ranged between 0.83 and 0.97. PCT cutoff of 8.18 ng/mL on day 2 had a sensitivity of 80% and specificity of 100% for prediction of infection development. Neither CRP levels nor leukocyte count could discriminate between the patients with and without infections at any time. Conclusions In contrast with CRP levels and leukocyte counts, measurement of PCT appears to be a useful diagnostic tool in detecting early infectious complications in LT patients.