Lipopolysaccharide-binding protein in critically ill neonates and children with suspected infection: comparison with procalcitonin, interleukin-6, and C-reactive protein.

Abstract

OBJECTIVE:

To evaluate markers of infection in critically ill neonates and children, comparing lipopolysaccharide-binding protein (LBP) with procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP).

DESIGN AND SETTING:

Prospective, observational study in the level III multidisciplinary neonatal and pediatric intensive care unit.

PATIENTS:

Sixty patients with systemic inflammatory response syndrome (SIRS) and suspected infection classified into two groups: SIRS/sepsis ( n=33) and SIRS/no sepsis ( n=27). We included 29 neonates aged less than 48 h (neonates <48 h), 12 neonates older than 48 h (neonates >48 h), and 19 children. Median disease severity was high in neonates aged under 48 h and moderate in neonates aged over 48 h and children.

INTERVENTIONS:

Serum LBP, PCT, IL-6, and CRP were measured on two consecutive days. Area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and predictive values were evaluated.

RESULTS:

Serum LBP was higher in patients with SIRS/sepsis than in patients with SIRS/no sepsis. AUC for LBP on the first day of suspected infection was 0.89 in the younger neonates, 0.93 in the older neonates, and 0.91 in children.

CONCLUSIONS:

In critically ill neonates aged under 48 h LBP on the first day of suspected infection is a better marker of sepsis than IL-6 and PCT, and is similar to CRP. In critically ill neonates aged over 48 h and children LBP is a better marker than IL-6 and CRP, and is similar to PCT.

• Authors: Maja Pavcnik-Arnol, Sergej Hojker, Metka Derganc
• Journal: Intensive care medicine (Intensive Care Med) Vol. 30 Issue 7 Pg. 1454-60 (Jul 2004) ISSN: 0342-4642 [Print] United States
• PMID: 15127192 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Acute-Phase Proteins
• Biomarkers
• CALCA protein, human
• Carrier Proteins
• Interleukin-6
• Membrane Glycoproteins
• Protein Precursors
• lipopolysaccharide-binding protein
• Calcitonin
• C-Reactive Protein
• Calcitonin Gene-Related Peptide

Topics

• Acute-Phase Proteins
• Adolescent
• Age Factors
• Biomarkers (blood)
• C-Reactive Protein (analysis)
• Calcitonin (blood)
• Calcitonin Gene-Related Peptide
• Carrier Proteins (blood)
• Child
• Child, Preschool
• Critical Illness
• Humans
• Infant
• Infant, Newborn
• Intensive Care Units, Neonatal
• Intensive Care Units, Pediatric
• Interleukin-6 (blood)
• Membrane Glycoproteins (blood)
• Prospective Studies
• Protein Precursors (blood)
• Sensitivity and Specificity
• Sepsis (blood, diagnosis)
• Systemic Inflammatory Response Syndrome (blood, diagnosis)