Evaluation of procalcitonin, c reactive protein (CRP), neutrophil / lymphocyte ratio (NLR), platelet / lymphocyte ratio (PLR), PRO BNP and peripheral smear findings in patients with sepsis in intensive care

Introduction and Objective: Sepsis is one of the major causes of mortality and morbidity in intensive care units. Our study aims to investigate demographic characteristics, such as age and gender, CRP, procalcitonin, Neutrophil lymphocyte ratio, Platelet-lymphocyte ratio, pro-BNP, peripheral blood smear findings and various laboratory parameters of patients followed up with the diagnosis of sepsis in the pediatric intensive care unit and the control group, and determine whether there is a correlation between them. Material and Method: In this retrospective and single-centered study, 70 patients diagnosed with sepsis, in the 0-18 age group, followed up in Pediatric Intensive Care Units of the Dicle University Faculty of Medicine, Department of Pediatrics, between January 2014 and May 2019, and 70 controls without any disease in the 0-18 age group were included for research without any differences in age and gender. Patients' demographic characteristics, such as age and gender, and laboratory parameters were obtained retrospectively from the patient files and our hospital records. Diagnosis of sepsis was based on criteria in the Pediatrics Emergency and Intensive Care Association's 2018 guideline. Patients with high or low leukocyte counts, according to the age, those whose body temperature was above 38.5 °C or below 36.0 °C, those with more than 10% immature neutrophils detected in peripheral propagation, patients with tachycardia 2 SD above the normal limits, independent of any stimulant or drug use, or those with bradycardia, independent of vagal stimulant or drug use were included in the study. C-reactive protein, Procalcitonin, pro-BNP, Neutrophil lymphocyte ratio, Platelet-lymphocyte ratio and other laboratory parameters were studied in our hospital laboratories. Peripheral smear samples were taken in the patient group before and after treatment, and painted with appropriate dyes and evaluated in our hospital. Results: Of the 70 patients followed up with the diagnosis of sepsis, 36 (51.4%) were male, 34 (48.6%) were female, and 36 (51.4%) of the controls were male and 34 (48.6%) were female. There was no statistically significant difference between the two groups in terms of gender. The average age of the 70 patients in the patient group was 37,500, and the average age of the 70 controls was 41,00. In the sepsis group patients, CRP, PCT, mean leukocyte and neutrophil/lymphocyte ratio were statistically significantly higher than that of the controls. There was a statistically significant difference between the sepsis group and the post-treatment group in terms of glucose values, but this was probably caused by high glucose due to stress hyperglycemia. A statistically significant elevation was found between the post-treatment group and the control group in terms of ALT values. This condition was thought to be caused by the elevated transaminase due to the use of antibiotics. There was no statistically significant difference between the groups in terms of PLO. Conclusion: We suggest that NLO, CRP and PCT, which are the biomarkers we evaluated for prognostic follow-up, may be used as inflammatory markers in the diagnosis and follow-up of sepsis patients in intensive care units, where there are increased mortality and morbidity due to sepsis and where early diagnosis and treatment is of utmost importance due to increased hospitalization times, treatment difficulties and additional costs. Keywords: Sepsis, NLO, PLO, CRP, PCT, pro-BNP