Comparison of procalcitonin, sCD14 and interleukin-6 values in septic patients

The aim of the study was to investigate whether procalcitonin, soluble CD14 and interleukin-6 show advantages in predicting the outcome and specificit y for bacterial infection in patients with sepsis in comparison to common C -reactive protein measurement. Laboratory parameters were measured in plasm a of patients during 14 days following the diagnosis of sepsis. Patients fu lfilling the ACCP/SCCM criteria for sepsis were admitted to an intensive ca re unit (n=35). Procalcitonin was measured with an immunoluminometric assay , and soluble CD14 and interleukin-6 were analysed by ELISA. C-reactive pro tein was determined nephelometrically. Measurements were performed on days 0, 1, 2, 3, 4, 7 and 14. Separating the patients into survivors (n=22) and non-survivors (n=13), it was demonstrated that non-survivors mostly exhibit ed, after the day of admission, increasing procalcitonin concentrations whi ch peaked around days three and four. In contrast, the procalcitonin concen trations of survivors fell continuously to the value of 2.1 ng/ml which was reported to be important for patients prognosis. The difference between pr ocalcitonin median values of survivors (n=22) and non-survivors (n=13) atta ined the level of statistical significance on day 7 and on day 14 (p=0.05). When comparing the median Values of C-reactive protein, soluble CD14 and i nterleukin-6 between survivors and non-survivors, no significant difference s were detectable. In this study, plasma concentrations of soluble CD14 and interleukin-6 showed no predictive value for patients' outcome as compared with established laboratory parameters such as C-reactive protein or leuko cyte count. Monitoring of procalcitonin seemed to detect severe episodes of sepsis and may improve the laboratory monitoring of septic patients.