Granulocyte elastase compared to C-reactive protein for early diagnosis of septicemia in critically Ill patients

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Abstract
Plasma levels of granulocyte elastase and C-reactive protein were measured 0, 12, 24 and 48 h after suspicion of septicemia in 64 critically ill patients. Initial elastase levels were higher in 16 bacteremic patients (mean 773µg/l) than in 48 non-bacteremic patients (mean 341µg/l, p<0.01), whereas C-reactive protein levels were similar in both groups. At a level of 100 % sensitivity for the early detection of septicemia, increased elastase was less than 50 % specific, indicating limited diagnostic usefulness in this setting.