Understanding Procalcitonin in Sepsis
When you’re taking care of patients with sepsis, you may hear the medical team talking about all the findings that indicate your patient is in trouble: elevated white count, elevated lactate, fever, infection source, tachycardia, hypotension and so on. You may also hear them refer to the procalcitonin level. So, what is procalcitonin and what does it mean for your patient?
Procalcitonin is a substance released in response to a bacterial infection or tissue injury. In a study published in Journal of Intensive Care, researchers state that a rapid rise in procalcitonin during the infective process is “an ideal biomarker for bacterial infection.”
So, if you’re on the fence if your patient’s elevated lactate, tachycardia and hypotension are due to sepsis…take a look at the procalcitonin level. If it’s elevated then this is definitely something you want to bring to the attention of the medical team.
Procalcitonin is going to rise more quickly than the C-reactive protein (CRP), which is another indicator of the inflammatory response in sepsis. It is also going to show bacteremia more quickly than a blood culture, which can take several days to confirm. In other words, procalcitonin can confirm a septic bacteremia faster than other diagnostic tests, though it is important to note that it is used in CONJUNCTION with other tests and should never be relied on as the sole indicator of sepsis.
In addition, when the patient is provided antibiotics, you’ll be able to trend the procalcitonin to see if the patient is responding to treatment. If procalcitonin returns to normal levels after the patient is treated, this is another clear indicator that the patient is suffering from sepsis.
If you’re looking for more information about sepsis, here are a few other posts you might like:
Why an elevated lactate isn’t always sepsis
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Vijayan, A. L., V., Ravindran, S., Saikant, R., Lakshmi, S., Kartik, R., & G, M. (2017). Procalcitonin: A promising diagnostic marker for sepsis and antibiotic therapy. Journal of Intensive Care,5(1). doi:10.1186/s40560-017-0246-8