Procalcitonin: back to basics

Procalcitonin in sepsis

PCT appeared to be most helpful in differentiating patients with sepsis from those with SIRS. Median PCT levels on admission (ng/ml, range) were 0.6 (0 to 5.3) for SIRS; 3.5 (0.4 to 6.7) for sepsis, 6.2 (2.2 to 85) for severe sepsis; and 21.3 (1.2 to 654) for septic shock (p < 0.001).

Diagnostic performance of different sepsis indicators

		Procalcitonin		Interleukin-6		Interleukin-8
Cutoff value, ng/ml		1.1		200		30
Sensitivity, %		97		67		63
Specificity, %		78		72		78
Positive predictive value, %		94		89		90
Negative predictive value, %		88		39		39
Area under the receiver operating		0.92		0.75		0.71
curve (95% confidence interval)		(0.85–1.0)		(0.63–0.87)		(0.59–0.83)

Harbarth S et al. Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis. Am. J. Respir. Crit. Care Med.August 1, 2001 vol. 164 no. 3 396-402

Procalcitonin in multiorgan failure

Organ dysfunction status	PCT (mean ± SE; ng/mL)
Patients not progressing to MODS	4.47 ± 1.22
ARDS	10.48 ± 4.77
ARDS plus ARF	8.08 ± 2.25
ARDS plus ARF plus DIC	32.72 ± 13.41
ARDS plus ARF plus DIC plus HF	43.35 ± 20.98

• Savitri Kibe, 
• Kate Adams, 
• and Gavin Barlow.
 Diagnostic and prognostic biomarkers of sepsis in critical care. J. Antimicrob. Chemother. (2011) 66(suppl 2): ii33-ii40 doi:10.1093/jac/dkq523