Combined estimation of Procalcitonin (PCT) and Lactate in sepsis patients under intensive care in a tertiary care hospital

Sepsis occurs in approximately 2 percent of all hospitalizations in developed countries and between 6-30 percent of all intensive care unit (ICU) patients. Biomarkers can help in early diagnosis, evaluation of severity, prognosis, predicting the complications of sepsis and development of organ dysfunction. Procalcitonin (PCT), a precursor of the hormone calcitonin has been proposed as a more specific and better prognostic marker. Serum PCT levels have also been noted to increase with increasing severity of sepsis and organ dysfunction. Sepsis is also understood to be a state of anaerobic metabolism and delivers the products of the same to tissues especially the organs with a high metabolic rate. Lactate is a by-product of anaerobic metabolism and hence considered as a marker for tissue hypoperfusion. Surviving sepsis campaign recommends lactate level estimation at admission in deciding the management of sepsis patients. PCT was the best independent variable to identify sepsis and lactate was the best to diagnose severe sepsis. So combined testing for PCT and lactate might offer more insight into the prognosis and management of sepsis patients.