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The value of procalcitonin in systemic inflammatory response syndrome after open-heart surgery for CHD

Published online by Cambridge University Press:  23 September 2019

Kuntum Basitha ,
Rubiana Sukardi ,
Ratna Farida Soenarto  and
Suprayitno Wardoyo
Kuntum Basitha
Affiliation:
Emergency Department, Ir. Soekarno District Hospital, Sukoharjo, Indonesia
Rubiana Sukardi*
Affiliation:
Integrated Cardiovascular Center, Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
Ratna Farida Soenarto
Affiliation:
Department of Anesthesia and Intensive Care, Ciptomangunkusumo National General Hospital, Jakarta, Indonesia
Suprayitno Wardoyo
Affiliation:
Thoracic, Cardiac, and Vascular Surgery, Department of Surgery, Ciptomangunkusumo National General Hospital, Jakarta, Indonesia
*
Author for correspondence: R. Sukardi, Dr Cipto Mangunkusumo Hospital, Integrated Cardiovascular Center, Jalan Diponegoro 71, Jakarta 10430, Indonesia. Tel: +6221 390 5839; E-mail: rubiana_sukardi@yahoo.com
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Abstract

Bakground:

Systemic inflammatory response syndrome, which is marked by fever, is a possible complication after open-heart surgery for CHD. The inflammatory response following the use of cardiopulmonary bypass shows similar clinical signs with sepsis. Therefore serial measurements of procalcitonin, an early infection marker, can be helpful to differentiate between sepsis and systemic inflammatory response syndrome.

Objectives:

To evaluate serial levels of procalcitonin in children who underwent open-heart surgery for cyanotic and acyanotic CHD, and identify factors associated with elevated level of procalcitonin.

Methods:

Children and infants who had open-heart surgery and showed fever within 6 hours after surgery were recruited. Procalcitonin levels were serially measured along with leukocyte and platelet count. Other data were also recorded, including diagnosis, age, body weight, axillary temperature, aortic clamp time, bypass time, duration of mechanical ventilation, risk adjustment for congenital heart surgery score-1, and length of stay in Cardiac ICU. The patients were categorised into cyanotic and acyanotic CHD groups.

Results:

High mean of procalcitonin level suggested the presence of bacterial infection. Cyanotic CHD group had significantly higher mean of procalcitonin level compared to acyanotic CHD group in the first two measurements. Both groups had no leukocytosis, though platelet count results were significantly different between the two groups. There was no significant difference of procalcitonin level observed in culture results and adverse outcomes.

Conclusion:

Serial procalcitonin measurement can be helpful to determine the cause of fever. Meanwhile other conventional markers such as leukocyte and platelet should be assessed thoroughly.

Keywords

ProcalcitoninCHDcardiopulmonary bypasssystemic inflammatory response syndrome
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 11 , November 2019 , pp. 1335 - 1339
Copyright
© Cambridge University Press 2019 

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