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Measurements of procalcitonin facilitate targeting of endotoxin adsorption treatment in febrile neutropenic patients suffering from shock.

Abstract
Immediate initiation of hemoperfusion treatment with polymixin B immobilized fiber (PMX-DHP) is a potent strategy to improve hemodynamics in septic patients with critical circulatory failure. However, it is often difficult to accurately and rapidly differentiate between bacterial infections and non-infectious causes of shock in acutely critically-ill patients. Procalcitonin (PCT) measurements may assist in the early identification of bacterial infection/sepsis and determination of severity in such patients. We present two febrile neutropenic (FN) patients who developed severe shock after chemotherapy for hematological malignancies. PCT levels were markedly elevated in both patients (≥ 10 ng/ml), suggesting a high likelihood of bacterial infectious etiology as the cause of their shock, and thus they were promptly treated with PMX-DHP. Measurements of PCT may facilitate targeting of PMX-DHP treatment among FN patients suffering from shock, which may lead to better prognosis.
AuthorsMasaki Hara, Ken Tsuchiya, Kosaku Nitta, Minoru Ando
JournalClinical nephrology (Clin Nephrol) Vol. 81 Issue 1 Pg. 67-70 (Jan 2014) ISSN: 0301-0430 [Print] Germany
PMID22909782 (Publication Type: Case Reports, Journal Article)
Chemical References
  • CALCA protein, human
  • Endotoxins
  • Protein Precursors
  • Calcitonin
  • Polymyxin B
  • Calcitonin Gene-Related Peptide
Topics
  • Adsorption
  • Adult
  • Calcitonin (blood)
  • Calcitonin Gene-Related Peptide
  • Endotoxins (isolation & purification)
  • Febrile Neutropenia (blood, complications)
  • Female
  • Hemoperfusion (methods)
  • Humans
  • Male
  • Polymyxin B (administration & dosage)
  • Protein Precursors (blood)
  • Shock, Septic (blood, etiology, therapy)

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