An evaluation of procalsitonin, the early defining agent of sepsis

VIII.SUMMARYSepsis defined as the systemic response of the tissue to the infection isone of the most common reasons for the deaths occuring in intensive careunits. While systemic inflammatory response formed in sepsis is revealedagainst the infection, a similar inflammatory response may be formed byother cases such us pancreatit, major trauma and burnt. It is significantly59important to determine the factor starting the systemic inflammation tostart the treatment protocol early and so get an early response. Commondiagnosis of systemic inflamation like tachicardia, difference in leukocyteand changesin the body temperature cannot be enough to distinguishinfectious, noninfectious and etiology. Since the clinical symptoms ofsystemic inflamation and bacteriyologic proof cannot always develop atthe same time and negative bakteriologic prof cannot reject the existenceof infection and sepsis, common diagnosis of systemic inflamation liketachicardia and changes in the body temperature and leucocyte are notthought to be reliable and enough. In this paper, in cases showingsystemic inflammation, PROCALC TONIN as a parameter which gives areliable information as to how serious is the sepsis and its prognoz andproviding the early diagnosis of a possible intection have been studied.We have included 23 adult patients in our study who have comewith a SIRS, sepsis, serious sepsis and septic shock diagnosis. Patientswere daily assessed with their plasma ProCT, white blood cell count andblood gas and scores of Apache II, SOFA and MODS have beenestimated from the point of view of sepsis intensity and its prognoz. Inaccordance with the ACCP/SCCM Consencus Conference Criteriapatients have been divided into four groups as SIRS, sepsis, serioussepsis and septic shock. Assessment came to an when the patients gotout of these criteria or were lost.Between SIRS, sepsis, serious sepsis and septic shock groups, ithas been observed that there has been a remerkable value for ProCT andthis was important to show the intensisty of sepsis.This is not valid for thenumber of leukocyte. When sensitivity and specifity are observed to showthe infection in the existence of SIRS, ProCT can be seen as a betterdiagnostic than the number of leukocyte. When AUCs of the ROC curvesare estimated, it is seen that the ProCT values are higher and sensitivityand specifity of ProCT is also higher. This means that while the number ofleukocyte has no meaning to show the infection fot the patients with SIRS,despite the bacteriologic method being the most important method, ProCT60can also be seen a significant symptom.Finally, it has been concluded that ProCT can be a sensitiveparameter to show the infection in cases with systemic inflamation and isan important symptom for the early diagnosis of sepsis.IX.KAYNAKLAR1. Knaus, W.A., Sun, X., Nystrom, P-O., Wagner, DP.: Evaluation of61