Procalcitonina y Proteína C-reactiva como predictores en el manejo de la sepsis quirúrgica
Keywords:
Procalcitonina, proteína C, infección, sepsisAbstract
Introducción: El síndrome de respuesta inflamatoria sistémica y la sepsis son respuestas inflamatorias a infecciones o traumatismos, que causan síntomas y resultados adversos, como el “fallo” de órganos y la muerte. Diferentes sistemas de puntuación ayudan en el diagnóstico. Biomarcadores como proteína C reactiva, la procalcitonina y los glóbulos blancos pueden servir como predictores de sepsis.
Metodo: Se realizaron búsquedas en bases de datos médicas en busca de literatura médica relevante. Se aplicaron criterios de elegibilidad y se identificaron 15 trabajos de investigación.
Resultados: Tanto la proteína C como la procalcitonina aumentan en pacientes postoperados y disminuyen gradualmente. En infección, estos niveles continúan aumentando. Los valores pueden guiar la toma de decisiones sobre cuándo iniciar antibióticos o dar de alta al paciente. La procalcitonina es más confiable para identificar la infección y prevenir el desarrollo de sepsis.
Conclusion: La proteína C y la procalcitonina son utiles en la detección temprana de sepsis y en la toma de decisiones. Estos biomarcadores pueden predecir la sepsis en pacientes posoperados. El reconocimiento temprano ayuda a mejorar el pronóstico general de los pacientes.
Downloads
References
1. Rudd KE, Johnson SC, Agesa KM. Global, regional, and national sepsis incidence and mortality, 1990- 2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395:200-11. DOI: https://doi.org/10.1016/S0140-6736(19)32989-7
2. Anush MM, Ashok VK, Sarma RI, Pillai SK. Role of C-reactive protein as an indicator for determining the outcome of sepsis. Indian J Crit Care Med. 2019;23:11-4. DOI: https://doi.org/10.5005/jp-journal-1007123105
3. Chomba RN, Moeng MS, Lowman W. Procalcitonin-guided antibiotic therapy for suspected and confirmed sepsis of patients in a surgical trauma ICU: a prospective, two period cross-over, interventional study. S Afr J Surg. 2020;5:143-9. DOI: https://doi.org/10.17159/2078-5151/2020/v58n3a3341
4. Siloşi CA, Siloşi I, Pădureanu V. Sepsis and identification of reliable biomarkers for postoperative period prognosis. Rom J Morphol Embryol. 2018;59:77-91. ISSN (online) 2066–8279. PMID: 29940615
5. Parli SE, Trivedi G, Woodworth A, Chang PK. Procalcitonin: usefulness in acute care surgery and trauma. Surg Infect (Larchmt). 2018;19:131-6. DOI: https://doi.org/10.1089/sur.2017.307
6. Vijayan AL. Procalcitonin: a promising diagnostic marker for sepsis and antibiotic therapy. J Intensive Care. 2017;5:51. DOI: https://doi.org/10.1186/s40560-017-0246-8
7. Urrechaga E. Reviewing the value of leukocytes cell population data (CPD) in the management of sepsis. Ann Transl Med. 2020;8(15):953. DOI: https://doi.org/10.21037/atm-19-3173
8. Patil HV, Patil VC. Comparative study of procalcitonin and C-reactive protein in patients with sepsis. J Nat Sc Biol Med 2020;11:93-9. DOI: https://doi.org/10.4103/jnsbm.JNSBM_1_20
9. Hu L, Shi Q, Shi M, Liu R, Wang C. Diagnostic value of PCT and CRP for detecting serious bacterial infections in patients with fever of unknown origin: A systematic review and meta-analysis. Appl Immunohistochem Mol Morphol 2017;25:e61-e69 .DOI: https://doi.org/10.1097/PAI.0000000000000552
10. Tang JH, Gao DP, Zou PF. Comparison of serum PCT and CRP levels in patients infected by different pathogenic microorganisms: A systematic review and meta-analysis. Braz J Med Biol Res 2018;51:e6783. DOI: https://doi.org/10.1590/1414-431X20176783
11. Sharma S, Duggal N. Role of procalcitonin, IL-6 and C- reactive protein in suspected cases of sepsis. Indian J Pathol Microbiol 2019;62:578-81. DOI: https://doi.org/10.4103/IJPM.IJPM_762_18
12. Mustafić S, Brkić S, Prnjavorac B, Sinanović A, Porobić Jahić H, Salkić S. Diagnostic and prognostic value of procalcitonin in patients with sepsis. Med Glas (Zenica) 2018;15:93-100. DOI: https://doi.org/10.17392/963-18
13. Hassan J, Khan S, Zahra R, Razaq A, Zain A, Razaq L, Razaq M. Role of Procalcitonin and C-reactive Protein as Predictors of Sepsis and in Managing Sepsis in Postoperative Patients: A Systematic Review. Cureus 2022;14(11):e31067. DOI: https://doi.org/10.7759/cureus.31067
14. Franeková J, Protuš M, Kieslichová E, Březina A, Komrsková J, Vymětalík J, Jabor A. Changes in sepsis biomarkers after immunosuppressant administration in transplant patients. Mediators Inflamm. 2021;2021:8831659. DOI: https://doi.org/10.1155/2021/8831659
15. Jerome E, McPhail MJ, Menon K. Diagnostic accuracy of procalcitonin and interleukin-6 for postoperative infection in major gastrointestinal surgery: a systematic review and meta-analysis. Ann R Coll Surg Engl. 2022;104:561-70. DOI: https://doi.org/10.1308/rcsann.2022.0053
16. Sariego-Jamardo A, Rey C, Medina A, Mayordomo-Colunga J, Concha-Torre A, Prieto B, Vivanco-Allende A. C-reactive protein, procalcitonin and interleukin-6 kinetics in pediatric postoperative patients. J Crit Care. 2017;41:119-23. DOI: https://doi.org/10.1016/j.jcrc.2017.05.009
17. Arbutina DD, Milic L, Cuk VV, Juloski JT, Radulovic R, Starcevic A, Karamarkovic AR. Significance of biomarkers in early diagnosis of abdominal sepsis. Chirurgia (Bucur). 2022;117:30-6. DOI: https://doi.org/10.21614/chirurgia.2660
18. Nasimfar A, Sadeghi E, Karamyyar M, Manesh LJ. Comparison of serum procalcitonin level with erythrocytes sedimentation rate, C-reactive protein, white blood cell count, and blood culture in the diagnosis of bacterial infections in patients hospitalized in Motahhari Hospital of Urmia (2016). J Adv Pharm Technol Res 2018;9:147-52. DOI: https://doi.org/10.4103/japtr.JAPTR_319_18
19. Verlinden A, De Vroey V, Goossens H, Roelant E, Van De Velde AL, Berneman ZN. Comparison of the Power of Procalcitonin and C-Reactive Protein to Discriminate between Different Aetiologies of Fever in Prolonged Profound Neutropenia: A Single-Centre Prospective Observational Study. Mediterr J Hematol Infect Dis 2019;11:e2019023. DOI: https://doi.org/10.4084/MJHID.2019.023
20. Niu T, Liu Y, Zhu F, Ma J, Gao J. Time-resolved fluorescent immunoassay-based combined detection of procalcitonin, C-reactive protein, heparin binding protein, and serum amyloid A1 to improve the diagnostic accuracy of early infection. J Clin Lab Anal 2019;33:e22694. DOI: https://doi.org/10.1002/jcla.22694
21. Eun-Hwa L, Kyoung-Hwa L, Young-Goo S, Sang-Hoon H. Discrepancy of C-Reactive Protein, Procalcitonin and Interleukin-6 at Hospitalization: Infection in Patients with Normal C-Reactive Protein, Procalcitonin and High Interleukin-6 Values. J. Clin. Med. 2022;11:7324. DOI: https://doi.org/10.3390/jcm11247324
22. Ogulur I, Pat Y, Ardicli O, Barletta E, Cevhertas L, Fernandez-Santamaria R, Huang M, Bel Imam M, Koch J, Ma S. Advances and highlights in biomarkers of allergic diseases. Allergy 2021;76:3659-86. DOI: https://doi.org/10.1111/all.15089
23. Haag E, Molitor A, Gregoriano C, Müller B, Schuetz P. The value of biomarker-guided antibiotic therapy. Expert Rev. Mol. Diagn 2020;20:829-40. DOI: https://doi.org/10.1080/14737159.2020.1782193
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Horacio Inocencio Tabares Neyra
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
