New reference ranges of procalcitonin excluding respiratory
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Existing reference data on serum procalcitonin (PCT) in neonates include the effects of respiratory disorders commonly occurring during birth. A study was conducted aimed to determine new 95% reference intervals in neonates after excluding respiratory failure influence at birth and investigate the effects of gestational age (GA) and respiratory condition at birth on the postnatal transient serum PCT elevation.

Samples were obtained from term and preterm neonates during the first 3 days of life. Neonates were classified into reference, respiratory failure, and bacterial infection groups. In the reference group, the correlation between PCT level and GA was investigated. The median PCT level within the 95% range during 12–36 h after birth was 1.05 ng/mL in term neonates 143 samples and 1.01 ng/mL in preterm neonates 95 samples. There was no correlation between GA and serum PCT levels during 1–48 h after birth. There was a significant difference in median serum PCT level during 12–36 h after birth between the respiratory failure 9.56 ng/mL and bacterial infection 49.82 ng/mL groups in preterm neonates but no difference between term neonates (respiratory failure and bacterial infection).

Respiratory failure is the main effector for the transient elevation in serum PCT levels at 3 days of life. After excluding respiratory failure influence, the chronological pattern and range were highly similar between term and preterm neonates. PCT can be useful for clinicians in distinguishing bacterial infection from respiratory failure, aiding decisions on appropriate antibiotic use.