Abstract
Background: The reasons for a systemic inflammatory response syndrome (SIRS) following ECC are
not yet fully understood. Procalcitonin (PCT) blood levels may distinguish between
bacterial infections and a non-bacterial systemic inflammation. We investigated the
influence of ECC, ECC modified by application of aprotinin, systemic inflammation,
and bacterial infection on the PCT values. Methods: 20 CABG patients were randomized and divided in two groups. Group A served as the
control group, while group B perioperatively received a high dose of aprotinin. Blood
samples for measurement of PCT were taken 6 times perioperatively. Furthermore, blood
samples were taken from 20 preoperatively comparable patients who suffered from bacterial
infection (n = 10) (group C) or a SIRS (n = 10) (group D) after ECC; in these groups
PCT was determined daily after the onset of inflammation. Results: There was no significant elevation of PCT in group A or B at any time. In sepsis
patients a significant elevation of PCT was seen, with the peak level of 18.6 ± 6.3
ng/ml on the second day after diagnosis; the PCT level of SIRS patients remained constantly
low (< 0.9 ng/ml). Conclusions: In this study it was demonstrated that ECC and the use of aprotinin did not have
any influence on the secretion of PCT. A systemic bacterial infection caused a significant
increase of PCT, whereas PCT values remained normal in case of a SIRS. So it seems
to be possible to distinguish between a primary SIRS and a bacterial sepsis by means
of PCT.
Key words
Procalcitonin - C-reactive protein - Systemic inflammatory response syndrome - Sepsis
- Cardiopulmonary bypass Aprotinin
