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PROCALCITONIN ON POSTOPERATIVE INFECTION AFTER PEDIATRIC CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS
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Abstract
Objectives: Diagnosing infection in children after cardiac surgery with cardiopulmonary bypass remains challenging. This study aims to determine the value of procalcitonin in the diagnosis of postoperative infection in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass. Materials and methods: Longitudinal prospective study with 50 patients undergoing cardiac surgery with cardiopulmonary bypass from December 1, 2021 to May 31, 2023 at City Children's Hospital were included in the study. PCT was tested before surgery, immediately after surgery and on postoperative day 3. Diagnostic criterias for postoperative infection according to Centers for Disease Control and Prevention (CDC) 2008. Area under the curve was used to evaluate the value of PCT in diagnosing postoperative infection. Results: 33 patients were postoperative infections. Median PCT at the time immediately after surgery and postoperative day 3 were 1.9(0,7-16,8) ng/ml and 7.3(5,1-12,1) ng/ml. The variation of PCT on postoperative day 3 compared to immediately after surgery and the percentage difference of PCT on postoperative day 3 compared to immediately after surgery did not have a significant difference between the infected and noninfected groups. The area under the curve (AUC) of PCT for diagnosis of infection on postoperative day 3 was 0.67, the optimal cut-off values 9.22 ng/ml, sensitivity 48.5%, specificity 70.6% with positive predictive value 76.2%, negative predictive value 41.4%. The AUC of combining PCT, WBC and CRP on postoperative day 3 was 0.81, sensitivity 75.8%, specificity 80%, positive predictive value 89.3%, negative predictive value 60%. Conclusions: PCT at the time immediately after surgery, postoperative day 3 has no value in diagnosing postoperative infection. The combination of PCT, WBC and CRP on postoperative day 3 has better value in diagnosing postoperative infection in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass.
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Keywords
postoperative infection, Procalcitonin, cardiac surgery with cardiopulmonary bypass.
References
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