Critical Care and Shock

Procalcitonin levels as predictors of neurological outcome in patients with cardiac arrest treated with mild therapeutic hypothermia: a retrospective study

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Background/objective: Procalcitonin (PCT) is a biomarker widely used to identify bacterial infections, diagnostic tool for sepsis, monitor response to antibacterial therapy, and to assess general inflammatory response. Our goal was to assess the relationship between PCT levels and neurological outcome in patients who suffered cardiac arrest (CA), and underwent mild therapeutic hypothermia (TH) at 32 °C for a period of 24 hours.
Methods: 55 patients with CA who underwent mild TH were enrolled. Three PCT measurements were obtained (PCT-1 prior to TH, PCT-2 during TH and PCT-3 after TH). Neurological outcome was evaluated with the Cerebral Performance Category (CPC) score. Descriptive statistics and analysis of variance (t-test and ANOVA) were used.
Results: From our cohort, 58.6% had a CPC≥3, 29.3% CPC 1 and 6.9% CPC 2. Mean PCT levels for each group were: PCT CPC 1 2.43 (+3.940 SD), PCT CPC 2 5.49 (+1.516 SD), and PCT CPC>3 4.077 (+8.805 SD). ANOVA between PCT-1 and CPC scores was F=0.354 (p=0.697), PCT-2 and CPC scores F=0.71 (p=0.501), and PCT-3 and CPC scores F=0.710 (p=0.496).
Conclusion: Our small sample size led to a significant difference of distribution. Further prospective studies with bigger samples are needed in order to obtain better results when assessing the significance of PCT levels as predictors of neurological outcome after CA and TH.