Diagnostic potential of neutrophil elastase inhibitor complex in the routine care of critically ill newborn infants.

Détails

ID Serval
serval:BIB_D943284E3ACD
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Diagnostic potential of neutrophil elastase inhibitor complex in the routine care of critically ill newborn infants.
Périodique
European journal of pediatrics
Auteur(s)
Fischer J.E., Brunner A., Janousek M., Nadal D., Blau N., Fanconi S.
ISSN
0340-6199
Statut éditorial
Publié
Date de publication
2000
Peer-reviewed
Oui
Volume
159
Numéro
9
Pages
659-62
Langue
anglais
Notes
Publication types: Journal Article - Publication Status: ppublish
Résumé
It has been suggested that determination of the neutrophil elastase alpha1-proteinase inhibitor complex (E-alpha1PI) improves the diagnosis of bacterial infection in newborns. We evaluated the use of E-alpha1PI measurements in 143 newborns, consecutively admitted to a tertiary intensive care unit, employing a new random access assay and a sampling procedure that minimises post-collection artefacts. The 95% range for noninfected newborns was 20-110 microg/l up to the 5th day of life and 20-85 microg/l thereafter. The sensitivity as to the diagnosis of culture-proven bloodstream infection was 80% for E-alpha1PI, 86% for the immature to total neutrophil ratio, 64% for C-reactive protein and 37% for the total white blood cell count. The corresponding specificity amounted to 97%, 85%, 85% and 86%, respectively. E-alpha1PI increases preceded elevations of C-reactive protein by 18 h. Like C-reactive protein, E-alpha1PI levels did not distinguish between bloodstream infection and non-bacterial inflammatory responses. Results of E-alpha1PI became available within 1 h of collection and usually 2-3 h before manual leucocyte counts. CONCLUSION: Determination of neutrophil elastase alpha1-proteinase inhibitor levels yields diagnostic advantages comparable to those of manual differential counts but provide faster turnaround times.
Mots-clé
Cohort Studies, Critical Illness, Humans, Infant, Newborn, Leukocyte Elastase, Prospective Studies, Sensitivity and Specificity, Sepsis, alpha 1-Antitrypsin
Pubmed
Web of science
Création de la notice
25/01/2008 11:07
Dernière modification de la notice
03/03/2018 21:52
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