• Ronaldo Arkader, Eduardo Juan Troster, Deipara Monteiro Abellan, Marcel Rezende Lopes, Roberto Raiz Júnior, Joseph A Carcillo, and Thelma Suely Okay.
• Department of Pediatrics, School of Medicine, University of São Paulo, São Paulo, Brazil.
• J. Cardiothorac. Vasc. Anesth. 2004 Apr 1; 18 (2): 160-5.

ObjectiveTo determine the kinetics of procalcitonin (PCT) and C-reactive protein (CRP) concentration after pediatric cardiac surgery with cardiopulmonary bypass.DesignProspective, clinical cohort study.SettingA fifteen-bed tertiary-care pediatric intensive care unit.PatientsFourteen pediatric patients admitted for cardiac surgery.Measurements And Main ResultsSerum PCT and CRP were measured before cardiopulmonary bypass (CPB); after CPB; and on the first, second, and third days after surgery by means of immunoluminometry and nephelometry, respectively. Reference values for systemic inflammatory response syndrome are 0.5 to 2.0 ng/mL for PCT and <5 mg/L for CRP. Baseline serum PCT and CRP concentrations were 0.24 +/- 0.13 ng/mL and 4.06 +/- 3.60 mg/L (median 25th percentile-75th percentile), respectively. PCT concentrations increased progressively from the end of CPB (0.62 +/- 0.30 ng/mL), peaked at 24 hours postoperatively (POD1) (0.77 +/- 0.49 ng/mL), and began to decrease at 48 hours or POD2 (0.35 +/- 0.21 ng/mL). CRP increased just after CPB (58.82 +/- 42.23 mg/L) and decreased after 72 hours (7.09 +/- 9.81 mg/L).ConclusionAn increment of both PCT and CRP was observed just after CPB. However, PCT values remained within reference values, whereas CRP concentrations increased significantly after CPB until the third day. These preliminary results suggest that PCT was more effective than CRP to monitor patients with SIRS and a favorable outcome.

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