Procalcitonin Guided Therapy in Intensive Care Patients with Septic Shock

Abstract

S epsis is defined as the presence of an infection accompanied by systemic inflammatory response syndrome. Systemic inflammatory response syndrome is defined as the presence of 2 or more of the following: temperature greater than 38°C (100.4°F) or less than 36°C (96.8°F); pulse rate greater than 90 beats/min; respiratory rate greater than 20 breaths/min (or PaCO2 less than 32mmHg); and WBC count greater than 12,000/mm3 or less than 4,000/mm3, or greater than 10% immature band forms. Severe sepsis is defined as the presence of sepsis and 1 or more organ dysfunctions. Septic shock is defined as the presence of sepsis and refractory hypotension. The incidence of sepsis increased 3-fold between 1979 and 2000. The reasons for this growing incidence likely include an increasingly elderly population, increased recognition of disease, increased performance of invasive procedures and organ transplantation, increased use of immunosuppressive agents and chemotherapy, increased use of indwelling lines and devices, and increase in chronic diseases such as end-stage renal disease and HIV.