Author/Editor     Pavčnik-Arnol, Maja; Hojker, Sergej; Derganc, Metka
Title     Lipopolysaccharide-binding protein in critically ill neonates and children with suspected infection: comparison with procalcitonin, interleukin-6, and C-reactive protein
Type     članek
Source     Intensive Care Med
Vol. and No.     Letnik 30, št. 7
Publication year     2004
Volume     str. 1454-60
Language     eng
Abstract     Objective To evaluate markers of infection in critically ill neonates and children, comparing lipopolysaccharide-binding protein (LBP) with procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP). Design and setting Prospective, observational study in the level III multidisciplinary neonatal and pediatric intensive care unit.Patients Sixty patients with systemic inflammatory response syndrome (SIRS) and suspected infection classified into two groups: SIRS/sepsis (n=33) and SIRS/no sepsis (n=27). We included 29 neonates aged less than 48 h (neonates <48 h), 12 neonates older than 48 h (neonates >48 h), and 19 children. Median disease severity was high in neonates aged under 48 h and moderate in neonates aged over 48 h and children. Interventions Serum LBP, PCT, IL-6, and CRP were measured on two consecutive days. Area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and predictive values were evaluated. Results Serum LBP was higher in patients with SIRS/sepsis than in patients with SIRS/no sepsis. AUC for LBP on the first day of suspected infection was 0.89 in the younger neonates, 0.93 in the older neonates, and 0.91 in children. Conclusions In critically ill neonates aged under 48 h LBP on the first day of suspected infection is a better marker of sepsis than IL-6 and PCT, and is similar to CRP. In critically ill neonates aged over 48 h and children LBP is a better marker than IL-6 and CRP, and is similar to PCT.
Descriptors     CRITICAL ILLNESS
SEPSIS
MEMBRANE GLYCOPROTEINS
INTERLEUKIN-6
CARRIER PROTEINS
INFANT, NEWBORN
CHILD
SENSITIVITY AND SPECIFICITY
PROTEIN PRECURSORS
PROSPECTIVE STUDIES
GLYCOPROTEINS
INTENSIVE CARE UNITS, PEDIATRIC
CALCITONIN
C-REACTIVE PROTEIN
ACUTE-PHASE PROTEINS