Interpreting Procalcitonin Values

Units:  ng/mL (normal <0.10)

Interpretation:

1. predicting progression to severe sepsis / septic shock (taken on D1 ICU admission)

  • >2 = high risk
  • <0.5 = low risk

2. As guide to Abx therapy in respiratory infections

  • <0.1 = ABx not needed
  • >0.5 = ABx needed

PCT-Algorithms-1 PCT-Algorithms-2 PCT-Algorithms-3 PCT-Algorithms-4bild_15_pct_04_06 procalcitonin-img Procalcitonin for diagnosis Figure 2

Basics:

  • precursor of calcitonin
  • produced by parafollicular cells of thyroid gland and neuroendocrine cells of lung / intestine / other tissues in response to inflammation, esp bacterial.
  • serum values correlate with severity of sepsis, recede with improvement, worsen with exacerbation.

Test performance:

  • Bacteremia (Sn 76%, Sp 70%)
  • systemic inflammatory response syndrome (SIRS)
  • sepsis
  • septic shock.
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