Intensive care medicine
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Intensive care medicine · Mar 2000
Procalcitonin for differential diagnosis of graft rejection and infection in patients with heart and/or lung grafts.
Investigation of the reliability of Procalcitonin (PCT) for differential diagnosis of acute rejections and non-viral infections in heart and lung transplanted patients. ⋯ PCT is a reliable predictor with discriminating power for non-viral systemic infections in patients after heart and/or lung transplantation. PCT allows an early differential diagnosis between rejection (AR) and bacterial/fungal infection (IF) and thus a rapid and focused therapeutic intervention. It avoids unnecessary antibiotic treatment which could be toxic for the graft itself in patients with rejection only. PCT provides vital information early to clinicians and allows them to improve the management of bacterial/fungal infections in immunocompromized transplant patients. PCT thus facilitates and improves the outcome of survival rate and the quality of life in the postoperative period of patients with heart and/or lung grafts.
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Intensive care medicine · Mar 2000
Procalcitonin for early diagnosis and differentiation of SIRS, sepsis, severe sepsis, and septic shock.
To determine the value of procalcitonin (PCT) in the early diagnosis (and differentiation) of patients with SIRS, sepsis, severe sepsis, and septic shock in comparison to C-reactive protein (CRP), white blood cell and thrombocyte count, and APACHE-II score (AP-II). ⋯ In contrast to AP-II, PCT appears to be a useful early marker to discriminate between sepsis and severe sepsis.
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Intensive care medicine · Mar 2000
Procalcitonin (PCT) is useful in predicting the bacterial origin of an acute circulatory failure in critically ill patients.
To evaluate the accuracy of procalcitonin (PCT) in predicting bacterial infection in ICU medical and surgical patients. ⋯ The increase of PCT is related to the appearance and severity of bacterial infection in ICU patients. Thus, PCT might be an interesting parameter for the diagnosis of bacterial infections in ICU patients.
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Intensive care medicine · Mar 2000
Circulating endothelin-1 and tumor necrosis factor-alpha: early predictors of mortality in patients with septic shock.
To determine the predictive value of early determination of tumor necrosis factor (TNF)-alpha, TNF-alpha 1 and 2 soluble receptors (sTNFR1 and sTNFR2) and endothelin-1 (ET-1) for mortality in patients with septic shock. ⋯ Increased levels of TNF-alpha were consistently higher at all time-points in nonsurvivors with septic shock. ET-1 levels, however, appeared also to be an early and sensitive predictor of mortality. Very early determination of TNF-alpha and ET-1 in septic shock may help to identify patients at higher risk for adverse outcome.
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To examine the relationships between early hyperlactataemia, acidosis, organ failure, and mortality in children admitted to intensive care. ⋯ Hyperlactataemia on admission to intensive care is associated with a high mortality in children. Nonsurvivors within this group may be distinguished by the peak lactate level, or by persistent hyperlactataemia after 24 h of treatment.