Procalcitonin serum concentrations do not differentiate severity of septic shock in postoperative patients

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Objectives

To investigate whether procalcitonin (PCT) serum concentrations differentiate severity of disease in postoperative/post-traumatic patients with septic shock, in which severity of shock is defined by different ranges of dosages of norepinephrine, necessary for cardiovascular stabilization.

Methods

Over a six month period, 192 patients admitted to the intensive care unit (ICU) were studied. Out of them, 18 patients were in a first phase of septic shock lasting at least four days. PCT serum concentrations in these patients were measured on days 1, 2, 4, 6, 8, 10, 12 and 14 after onset of septic shock until death or discharge from ICU. PCT was measured using a commercial immunoluminometric assay (BRAHMS Diagnostica, Berlin).

Results

Nine patients survived the episode of septic shock lasting 4–10 days. Nine patients died after 5–55 days. In six patients, maximal dosage of norepinephrine was ≤ 0.1 μg/kg×min (group 1), in five patients between >0.1 and ≤ 0.2 μg/kg×min (group 2), and in seven patients >0.2 μg/kg×min (group 3). Ranges of PCT serum concentrations overlapped between group 1, 2, and 3, with 1.2–67.6, 1.8–194.3, and 0.4–46.1 ng/ml of PCT, respectively, resulting in no significant differences of PCT values during septic shock between the three groups.

Conclusions

PCT serum concentrations are not a marker of severity of disease in patients with septic shock, if severity of shock is defined by certain ranges of dosages of norepinephrine.