C-reactive protein to predict intensive care unit readmission?

Objectives: The COVID-19 disease can manifest itself with acute respiratory distress syndrome, renal failure, and septic shock in critically ill patients. There are opinions that there is a correlation between high IL-6 levels and disease severity. In our intensive care unit, we evaluated the changes in the laboratory data and radiological involvement severity of our patients who underwent tocilizumab treatment and examined the appropriate laboratory parameter in the treatment follow-up and its effect on survival. Methods: In the critical patient follow-up of COVID-19, 17 of the 23 patients treated with tocilizumab had a mortal course (Group 1) and the remaining 6 (Group 2) were. The C-reactive protein, lactate dehydrogenase, IL-6, D-dimer, procalcitonin, albumin, and ferritin values, which were routinely screened in our clinic on the day of tocilizumab treatment and the 5th day after, were recorded. Both the change between the two groups and the change between days 1 and 5 were analyzed. Results: A total of 23 patients (55.35 ± 13.31 years) were included in the study. The computed tomography severity score assessed at the intensive care unit admission was statistically significantly higher in Group 2. The procalcitonin and lactate dehydrogenase values measured on day 5 after tocilizumab were significantly lower in Group 2. On the 5th day after treatment, the levels of C-reactive protein, ferritin, chest X-rays, IL-6 and D-dimer statistically significantly changed compared to the first day of the treatment. In correlation with the decrease in PCT as of the 5th day after tocilizumab administration, an increasing tendency was observed in 28-day survival. Conclusion: This study demonstrated that tocilizumab treatment may positively contribute to the treatment by decreasing cytokine levels. PCT and LDH follow-up before and after treatment in critically ill patients who are receiving tocilizumab treatment can give an idea about survival.

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Usefulness of Early C-Reactive Protein Kinetics in Response and Prognostic Assessment in Infected Critically Ill Patients: An Observational Retrospective Study

Acta Médica Portuguesa ◽

10.20344/amp.12143 ◽

2019 ◽

Vol 32 (12) ◽

pp. 737

Author(s):

Marta Ayres Pereira ◽

Ana Lídia Rouxinol-Dias ◽

Tatiana Vieira ◽

José Artur Paiva

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Antibiotic Therapy ◽

Critically Ill ◽

Fast Response ◽

C Reactive Protein ◽

Protein Kinetics ◽

Reactive Protein ◽

Prognostic Assessment ◽

One Year

Introduction: The ideal biomarker to assess response and prognostic assessment in the infected critically ill patient is still not available. The aims of our study were to analyze the association between early C-reactive protein kinetics and duration and appropriateness of antibiotic therapy and its usefulness in predicting mortality in infected critically ill patients.Material and Methods: We have carried out an observational retrospective study in a cohort of 60 patients with community-acquired pneumonia, aspiration pneumonia and bacteremia at an intensive care unit. We have collected C-reactive protein consecutive serum levels for eight days as well as duration and appropriateness of initial antibiotic therapy. C-reactive protein kinetic groups were defined based on the levels at days 0, 4 and 7. With a follow-up of one year, we have evaluated mortality at different time-points.Results: We have obtained three different C-reactive protein kinetic groups from the sample: fast response, delayed but fast response and delayed and slow response. We did not find statistically significant associations between C-reactive protein kinetics and early (intensive care unit, hospital and 28-days) or late (six months and one year) mortality and antibiotic therapy duration (p > 0.05). Although there were no statistically significant differences between the appropriateness of antibiotic therapy and the defined groups (p = 0.265), no patient with inappropriate antibiotic therapy presented a fast response pattern.Discussion: Several studies suggest the importance of this protein in infection.Conclusion: Early C-reactive protein kinetics is not associated with response and prognostic assessment in infected critically ill patients. Nevertheless, a fast response pattern tends to exclude initial inappropriate antibiotic therapy.

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Evaluation of C - reactive Protein, Albumin and the C - reactive Protein/Albumin Ratio as Prognostic Markers in Trauma Patients Admitted to Intensive Care Unit

British Journal of Medicine and Medical Research ◽

10.9734/bjmmr/2016/18931 ◽

2016 ◽

Vol 12 (10) ◽

pp. 1-7

Author(s):

Farhad Soltani ◽

Mohammad Pipelzadeh ◽

Reza Akhondzadeh ◽

Mahbobe Rashidi ◽

Alireza Ekrami

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Prognostic Markers ◽

Trauma Patients ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein

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The Role of C-Reactive Protein and the SOFA Score as Parameter for Clinical Decision Making in Surgical Patients during the Intensive Care Unit Course

PLoS ONE ◽

10.1371/journal.pone.0055964 ◽

2013 ◽

Vol 8 (2) ◽

pp. e55964 ◽

Cited By ~ 5

Author(s):

Zainna C. Meyer ◽

Jennifer M. J. Schreinemakers ◽

Paul G. H. Mulder ◽

Ruud A. L. de Waal ◽

Antonius A. M. Ermens ◽

...

Keyword(s):

Intensive Care Unit ◽

Decision Making ◽

Intensive Care ◽

Sofa Score ◽

Clinical Decision Making ◽

Clinical Decision ◽

Surgical Patients ◽

C Reactive Protein ◽

Reactive Protein

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Hubungan Penanda Infeksi, Penanda Oksigenasi, dan Faktor Risiko Lainnya terhadap Mortalitas Pasien COVID-19 dengan Pneumonia Saat Admisi di Unit Perawatan Intensif RSUP Dr. Wahidin Sudirohusodo

JAI (Jurnal Anestesiologi Indonesia) ◽

10.14710/jai.v13i2.37050 ◽

2021 ◽

Vol 13 (2) ◽

pp. 114-124

Author(s):

Andi Taufik Amiruddin ◽

Haizah Nurdin ◽

Syafri Kamsul Arif ◽

Andi Muhammad Takdir Musba ◽

Andi Salahuddin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Intensive Care Unit ◽

Intensive Care ◽

C Reactive Protein ◽

Reactive Protein

Latar Belakang: Organisasi Kesehatan Dunia (WHO) mendeklarasikan penyebaran dari coronavirus disease 2019 (COVID-19). Faktor risiko terhadap mortalitas pasien COVID-19 rawat intensive care unit (ICU) belum banyak diteliti.Tujuan: Mengetahui hubungan penanda infeksi, penanda oksigenasi dan faktor risiko lainnya terhadap mortalitas pasien COVID-19 dengan pneumonia.Metode: Penelitian retrospektif dilakukan di ICU Infection Centre RSUP Dr. Wahidin Sudirohusodo, Makassar pada April – Agustus 2020. Sampel penelitian adalah data pasien COVID-19 dengan pneumonia yang dirawat di ICU. Pasien dibagi ke dalam dua kelompok survivor grup (SG) dan non-survivor (NSG). Variabel penelitian berupa penanda infeksi, penanda oksigenasi dan faktor risiko yang didapatkan dari rekam medis pasien. Analisis bivariat dan multivariat dilakukan terhadap semua variabel penelitian.Hasil: Dari 92 pasien didapatkan 46 NSG dan 46 SG. Perbandingan jenis kelamin dan indeks massa tubuh antara kedua kelompok tidak signifikan bermakna secara statistik. Tidak didapatkan perbedaan signifikan secara statistik pada level c-reactive protein (CRP) antara kelompok NSG dengan median 91,1 (IQR 32,3-200,45) dan SG 88,95 (IQR 33,50-177,80), p= 0,899. Faktor risiko usia tua, diabetes mellitus (DM), dan peningkatan rasio neutrofil-limfosit (RNL) berdasarkan klasifikasi cut-off signifikan secara statistik pada mortalitas antar kedua kelompok. Pada NSG didapatkan median usia 60,5 (IQR 53-67,25) vs SG 56 (IQR 35-61,25), p= 0.02. Komorbid DM SG 8 dari 46 pasien (17,4%) dan NSG 17 dari 46 pasien (37%), p = 0,035. Pemeriksaan kadar RNL berdasarkan klasifikasi cut-off > 3,4 NSG 42 dari 46 pasien (91,3%) dan NS 11 dari 46 (23,9%), p= 0,048. Analisis multivariat regresi logistik didapatkan rasio P/F merupakan faktor risiko independen. Mortalitas pasien COVID-19 dengan pneumonia (OR 0,99 95% CI 0,988-1,00, p = 0,043). Kesimpulan: Umur di atas 60 tahun, DM, RNL, dan indeks oksigenasi bermakna secara signifikan terhadap kejadian mortalitas pasien COVID-19 dengan pneumonia, dimana pada indeks oksigenasi yang rendah didapatkan kejadian mortalitas yang tinggi.

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C-reactive protein as a prognostic marker and guidance for use of antibiotic therapy in patients presenting with lower respiratory tract manifestations in intensive care unit in tertiary care centre

Panacea Journal of Medical Sciences ◽

10.18231/j.pjms.2020.027 ◽

2020 ◽

Vol 10 (2) ◽

pp. 117-124

Author(s):

Nisha ◽

◽

Uday G ◽

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Tract ◽

Antibiotic Therapy ◽

Lower Respiratory Tract ◽

Tertiary Care ◽

Care Centre ◽

C Reactive Protein ◽

Tertiary Care Centre ◽

Reactive Protein

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EFFECTS OF L-GLUTAMIN SUPLEMENTATION ON REDUCING C-REACTIVE PROTEIN (CRP) LEVELS AND LENGTH OF STAY IN INTENSIVE CARE UNIT POST LAPAROTOMY

International Journal of Medical Reviews and Case Reports ◽

10.5455/ijmrcr.l-glutamin-crp-levels-postlaparotomy ◽

2021 ◽

pp. 1

Author(s):

Daniel Daniel ◽

Pontisomaya Parami

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

C Reactive Protein ◽

Reactive Protein

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Ventilator-Associated Tracheobronchitis Increases the Length of Intensive Care Unit Stay

Infection Control and Hospital Epidemiology ◽

10.1086/671274 ◽

2013 ◽

Vol 34 (8) ◽

pp. 800-808 ◽

Cited By ~ 19

Author(s):

Marios Karvouniaris ◽

Demosthenes Makris ◽

Efstratios Manoulakas ◽

Paris Zygoulis ◽

Konstantinos Mantzarlis ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Protein Level ◽

Significant Risk ◽

University Hospital ◽

C Reactive Protein ◽

Prolonged Stay ◽

Reactive Protein ◽

Icu Stay ◽

The Impact

Objective.To investigate prospectively the clinical course and risk factors for ventilator-associated tracheobronchitis (VAT) and the impact of VAT on intensive care unit (ICU) morbidity and mortality.Design.Prospective cohort study.Setting.University Hospital Larissa, Larissa, GreecePatients.Critical care patients who received mechanical ventilation for more than 48 hours were prospectively studied between 2009 and 2011.Methods.The modified Clinical Pulmonary Infection Score, white blood cell count, and C-reactive protein level were systematically assessed every 2 days for the first 2 weeks of ICU stay. Bronchial secretions were assessed daily. Quantitative cultures of endotracheal secretions were performed on the first ICU day for every patient and every 2 days thereafter for the first 2 weeks or more at the discretion of the attending physicians. Definition of VAT was based on previously published criteria.Results.A total of 236 patients were observed; 42 patients (18%) presented with VAT. Gram-negative pathogens, which were usually multidrug resistant, were responsible for 92.9% of cases. Patients with a neurosurgical admission presented with VAT significantly more often than did other ICU patients (28.5% vs 14.1%; P = .02). The occurrence of VAT was a significant risk factor for increased duration of ICU stay (OR [95% CI], 3.04 [1.35-6.85]; P = .01). Age (OR [95% CI], 1.04 [1.015-1.06]; P = .02), Acute Physiology and Chronic Health Evaluation II score (OR [95% CI], 1.08 [1.015-1.16]; P = .02), and C-reactive protein level at admission (OR [95% CI], 1.05 [1.011.1]; P = .02) were independent factors for ICU mortality.Conclusions.VAT is a nosocomial infection that might be associated with prolonged stay in the ICU, especially in neurocritical patients. VAT was not associated with increased mortality in our study.

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