Postoperative plasma concentrations of procalcitonin after different types of surgery

Introduction

Procalcitonin (PCT) is an inflammatory induced protein indicating severe bacterial infection or systemic inflammation in critically ill patients. To use PCT for diagnosis of infection or systemic inflammation also in the postoperative period, PCT should not substantially be induced by the surgical trauma in patients with a regular postoperative course. We thus measured PCT and CRP plasma concentrations after different types of surgery in patients with a regular postoperative course.

Methods

Postoperative plasma concentrations of PCT and CRP were prospectively measured preoperative and 5 days postoperative in 117 patients with a regular postoperative course and no signs of infection or inflammation after different types of surgery (Table 1).

Results

Postoperative induction of PCT largely depends on the type of surgery. Intestinal surgery and major abdominal operations more often increase PCT, whereas after primarily aseptic surgery PCT is normal in the majority of patients (Table 1). CRP concentrations were increased after all types of surgery (data not shown).

Conclusions

Postoperative moderately increased PCT plasma concentrations may be expected also without infection or inflammation in some patients after certain types of surgery. Since PCT concentrations are significantly more elevated during sepsis and severe bacterial infections, PCT might indicate infection or inflammation also postoperative. The significance of PCT for diagnosis of postoperative infections however should be evaluated by further investigations.

Table 1 Maximal postoperative PCT plasma concentrations (μg/l) of patients with a regular postoperative course during a 5 day observation period.