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Pediatric Cardiology

, Volume 40, Issue 6, pp 1289–1295 | Cite as

Procalcitonin Concentration Measured Within the First Days of Cardiac Surgery Is Predictive of Postoperative Infections in Neonates: A Case–Control Study

  • A. Aryafar
  • A. Di Marzio
  • O. Guillard
  • M. Pontailler
  • S. Vicca
  • M. BojanEmail author
Original Article
  • 168 Downloads

Abstract

Increased procalcitonin concentration (PCT) is known to be reliable for the identification of infections even in the presence of the non-specific systemic inflammatory response seen after cardiopulmonary bypass (CPB), whereas increased C-reactive protein concentration (CRP) is not. The present work explored the ability of neonate PCT measured early after cardiac surgery to identify postoperative infections. This was a retrospective case–control study, where PCT was matched between patients with and without infections according to the patient’s age, the CPB length, the use of deep hypothermic circulatory arrest (DHCA), and the postoperative day (POD). The accuracy in the prediction of infections was ascertained and cutoff thresholds were identified. 144 neonates were eligible, and 89 pairs of measurements from 94 patients were analyzed. PCT was a good predictor of infections within POD4, and was a better predictor when compared with CRP at POD1 and POD2. The sum of PCT (pg mL−1) and CRP (mg L−1) > 33 on POD1 or POD2 predicted infections with a 0.68 sensitivity and a 0.82 specificity, and a sum  > 49.36 on POD3 or POD4 predicted infections with a 0.82 sensitivity and a 0.93 specificity. In patients with DHCA, PCT was higher than in those without DHCA, and was not predictive of infections. The accuracy of PCT to identify infections after neonatal cardiac surgery is better than that of CRP when measured within 48 h of surgery. The sum of the two markers measured early after surgery is an excellent predictor of postoperative infections.

Keywords

Pediatric cardiac surgery Neonate Postoperative infection Procalcitonin 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors have no conflict of interest to declare.

Ethical Approval

This study was approved by the institutional ethical committee, who waived the need for written informed parental consent to perform this retrospective analysis, after de-identification of all patient data.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeonatologyNecker-Enfants Malades HospitalParis Cedex 15France
  2. 2.Department of NeonatologyCentre Hospitalier Sud FrancilienCorbeil-EssonnesFrance
  3. 3.Department of Anesthesiology and Critical CareErasme HospitalBrusselsBelgium
  4. 4.Congenital Cardiac UnitMarie Lannelongue HospitalLe Plessis RobinsonFrance
  5. 5.Department of Pediatric Cardiac SurgeryNecker-Enfants Malades HospitalParis Cedex 15France
  6. 6.Department of BiochemistryNecker-Enfants Malades HospitalParis Cedex 15France
  7. 7.Department of AnesthesiologyCongenital Cardiac Unit, Marie Lannelongue HospitalLe Plessis RobinsonFrance

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