179 WHAT IS THE VALUE OF C-REACTIVE PROTEIN FOR MANAGING “RULE OUT SEPSIS” IN HEALTHY TERM INFANTS SOON AFTER BIRTH?

2005 ◽  
Vol 53 (1) ◽  
pp. S284.3-S284
Author(s):  
J. Harden ◽  
S. Buchter ◽  
L. Mobley ◽  
A. Sola
Keyword(s):  
C Reactive Protein ◽  
Term Infants ◽  
Reactive Protein ◽  
Rule Out

scholarly journals CO-RADS versus CT-SS scores in predicting severe COVID-19 patients: retrospective comparative study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Niveen E. Zayed ◽  
Manar A. Bessar ◽  
Samah Lutfy
Keyword(s):  
Comparative Study ◽  
Severe Disease ◽  
Scoring Systems ◽  
Rt Pcr ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Polymerase Chain ◽  
Retrospective Comparative Study ◽  
Rule Out

Abstract Background The role of CT in assessing and plotting viral pulmonary affection land marking is its potential among other investigation tools, and the aim of the study was to compare the ability of two different CT-based scoring systems in discriminating severe COVID-19 disease. Results Retrospective comparative study included 142 confirmed COVID-19 patients by real-time polymerase chain reaction (RT-PCR) test, with different degrees of disease (mild to severe), the data of patients collected from medical records, and patients with their first CT chest read for calculating CO-RADS and severity scoring system (CT-SS) score. The patients with severe COVID-19 disease were significantly older and had different comorbidities. The level of C-reactive protein, ESR, ferritin, and LDH were significantly higher in severe disease, P < 0.001. The ability of CT chest and its score bases (CT-SS and CO-RADS) were accurate in differentiation between mild/moderate and severe disease; AUC were 89% and 97%, respectively. The cutoff value of less than 7.5 and 4.5 for CT-SS and CO-RADS, respectively, can rule out severe COVID-19 by 90% and 97%, respectively. Conclusions CT chest play a segregate role in COVID-19 disease, add on an advantage in clinical data in triage, and highlight the decision of hospital admission.

Role of umbilical interleukin-6, procalcitonin and C-reactive protein measurement in the dia gnosis of fetal inflammatory response syndrome

2021 ◽  
Vol 86 (2) ◽  
pp. 80-85
Author(s):  
Zbyněk Straňák ◽  
◽  
Ivan Berka ◽  
Jan Širc ◽  
Jan Urbánek ◽  
...  
Keyword(s):  
High Risk ◽  
Inflammatory Response ◽  
Neonatal Mortality ◽  
Interleukin 6 ◽  
C Reactive Protein ◽  
Term Infants ◽  
Mortality And Morbidity ◽  
Reactive Protein ◽  
High Risk Infants ◽  
Fetal Inflammatory Response

Overview Objective: Fetal Inflammatory Response Syndrome (FIRS) is a serious complication accompanied by increased neonatal mortality and morbidity. Early dia­gnosis of FIRS is essential to detect high risk infants. The aim of the study was to evaluate the correlation between interleukin-6 
(IL-6), procalcitonin (PCT), C-reactive protein (CRP) in cord blood and histologically proven funisitis/ chorioamnionitis in high-risk infants after preterm birth. Methods: Blood sampling for the measurement of inflammatory bio­markers was performed immediately after placental delivery and umbilical cutting. Umbilical and placental inflammatory changes were assessed using a recently released scoring system (Amsterdam Placental Workshop Group Consensus). Results: One hundred preterm infants (30.5 ± 2.5 gestational week, birth weight 1,443 ± 566 grams) and 21 health term infants were analyzed. Histologic chorioamnionitis was confirmed in 19% cases and chorioamnionitis with funisitis in 7% cases. Thirty-three infants (33%) fulfilled criteria of FIRS (funistis and/ or umbilical IL-6 > 11 ng/ L). The presence of FIRS correlated significantly with maternal leukocytosis (P < 0.001), preterm premature rupture of membrane (P < 0.001) and preterm uterine contraction (P < 0.0001). In comparison to preterm and healthy term infants we found statistically significant higher levels of umbilical inflammatory bio­markers (IL-6, PCT, CRP) in FIRS group (P < 0.0001). Composite mortality and morbidity (bronchopulmonary dysplasia, intraventricular haemorrhage, periventricular leukomalacia) was higher in FIRS group (28.1 vs 22.4% in preterm group). However, the difference was not statistically significant (P = 0.53). Conclusion: Our study confirmed the correlation of umbilical inflammatory bio­markers levels (IL-6, PCT, CRP) and the presence of FIRS. We did not find significant adverse impact of FIRS on neonatal mortality and morbidity. Nevertheless, our results could be influenced by the size of study group and strict inclusion criteria (only cases after C-section were analyzed). Keywords: fetal inflammatory response syndrome – neonatal mortality – morbidity – interleukin-6 – C-reactive protein – procalcitonin – chorioamnionitis and funisitis

scholarly journals An observational study of salivary C-reactive protein as a potential novel non-invasive biomarker of neonatal sepsis

2021 ◽  
Vol 36 ◽  
pp. 123-128
Author(s):  
Induparkavi Murugesan ◽  
Sanjeev B. Rai
Keyword(s):  
Neonatal Sepsis ◽  
Sample Collection ◽  
C Reactive Protein ◽  
Suspected Sepsis ◽  
Reactive Protein ◽  
Non Invasive ◽  
Invasive Method ◽  
Potential Clinical Utility ◽  
Serum Crp ◽  
Rule Out

Objectives: Serial C-reactive protein (CRP) monitoring helps to rule out and prognosticate sepsis. Small blood volumes in neonates make it difficult for repeated blood draws for serial CRP monitoring. Hence, the need of the hour is a non-invasive method such as CRP estimation in saliva. This study aims to correlate salivary CRP with serum CRP levels and establish the potential clinical utility of salivary CRP in diagnosing neonatal sepsis. Materials and Methods: Twenty-three consecutive neonates diagnosed with clinically suspected sepsis and admitted to the NICU were the study subjects. Demographics such as gestational age and weight at birth, sex and detailed clinical features, and comorbidities were noted. Blood samples for CRP estimation and blood culture were collected as soon as clinical suspicion of sepsis arose. Saliva samples were collected for CRP estimation within 1 h of blood sample collection. The saliva was collected in a 2 mL syringe using low suction. Salivary and serum CRP were estimated by the particle enhanced immunoturbidimetric assay. Results: In our study, the CRP levels in saliva correlated moderately well with CRP levels in serum (Spearman correlation coefficient r = 0.582, P = 0.004). The sensitivity and specificity of salivary CRP to predict a serum level of ≥10 mg/L were observed to be 0.75 and 0.93, respectively. Conclusion: Our study shows the promise of salivary CRP as a potential clinically meaningful biomarker of neonatal sepsis and warrants the need for larger studies to validate the utility of salivary CRP to serially monitor neonatal sepsis.

scholarly journals A simple tool to help ruling-out Covid-19 in the emergency department: derivation and validation of the LDH-CRP-Lymphocyte (LCL) score

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Jacopo Davide Giamello ◽  
Giulia Paglietta ◽  
Giulia Cavalot ◽  
Attilio Allione ◽  
Sara Abram ◽  
...  
Keyword(s):  
Validation Cohort ◽  
Negative Likelihood Ratio ◽  
C Reactive Protein ◽  
Derivation Cohort ◽  
Reactive Protein ◽  
Simple Tool ◽  
Lactate Dehydrogenase C ◽  
The Difference ◽  
To Receive ◽  
Rule Out

After the outbreak of the Covid-19 pandemic, cases of SARSCoV- 2 infections may gradually decrease in the next months. Given the reduced prevalence of the disease, Emergency Departments (ED) are starting to receive more and more non- Covid19 patients. Thus, a way to quickly discriminate ED patients with potential Covid-19 infection from non-Covid19 patients is needed in order to keep potentially contagious patients isolated while awaiting second-level testing. In this paper, we present the derivation and validation of a simple, practical, and cheap score that could be helpful to rule out Covid-19 among ED patients with suspicious symptoms (fever and/or dyspnoea). The LCL score was derived from a cohort of 335 patients coming to the ED of our hospital from March 16th to April 1st, 2020. It was then retrospectively validated in a similar cohort of 173 patients admitted to our ED during April. The score is based on blood values of lactate dehydrogenase, C-reactive protein, and lymphocyte count. The LCL score performed well both in the derivation and in the validation cohort, with an AUC respectively of 0.81 (95% CI: 0.77 – 0.86) and of 0.71 (95% CI: 0.63 – 0.78), given the difference in Covid- 19 prevalence between the two cohorts (57% vs 41% respectively). An LCL score equal to 0 had a negative predictive value of 0.92 in the derivation cohort and of 0.81 in the validation cohort, with a negative likelihood ratio respectively of 0.08 and 0.36 for Covid- 19 exclusion. This score could, therefore, constitute a useful tool to help physicians manage patients in the ED.

scholarly journals C-Reactive Protein, Procalcitonin, and White Blood Count to Rule Out Neonatal Early-onset Sepsis Within 36 Hours: A Secondary Analysis of the Neonatal Procalcitonin Intervention Study

2020 ◽  
Author(s):  
Martin Stocker ◽  
Wendy van Herk ◽  
Salhab el Helou ◽  
Sourabh Dutta ◽  
Frank A B A Schuerman ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Early Onset ◽  
Blood Count ◽  
Intervention Study ◽  
Secondary Analysis ◽  
White Blood Count ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Early Onset Sepsis ◽  
Rule Out

Abstract Background Neonatal early-onset sepsis (EOS) is one of the main causes of global neonatal mortality and morbidity, and initiation of early antibiotic treatment is key. However, antibiotics may be harmful. Methods We performed a secondary analysis of results from the Neonatal Procalcitonin Intervention Study, a prospective, multicenter, randomized, controlled intervention study. The primary outcome was the diagnostic accuracy of serial measurements of C-reactive protein (CRP), procalcitonin (PCT), and white blood count (WBC) within different time windows to rule out culture-positive EOS (proven sepsis). Results We analyzed 1678 neonates with 10 899 biomarker measurements (4654 CRP, 2047 PCT, and 4198 WBC) obtained within the first 48 hours after the start of antibiotic therapy due to suspected EOS. The areas under the curve (AUC) comparing no sepsis vs proven sepsis for maximum values of CRP, PCT, and WBC within 36 hours were 0.986, 0.921, and 0.360, respectively. The AUCs for CRP and PCT increased with extended time frames up to 36 hours, but there was no further difference between start to 36 hours vs start to 48 hours. Cutoff values at 16 mg/L for CRP and 2.8 ng/L for PCT provided a sensitivity of 100% for discriminating no sepsis vs proven sepsis. Conclusions Normal serial CRP and PCT measurements within 36 hours after the start of empiric antibiotic therapy can exclude the presence of neonatal EOS with a high probability. The negative predictive values of CRP and PCT do not increase after 36 hours.

77 CUTOFF VALUE OF SERUM C-REACTIVE PROTEIN ON THE FIFTH POSTOPERATIVE DAY IS EFFECTIVE TO RULE OUT ANASTOMOTIC LEAKAGE AFTER ESOPHAGECTOMY

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
V Hubaud ◽  
B Bottet ◽  
J Chenesseau ◽  
L Gust ◽  
I Bouabdallah ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Oral Feeding ◽  
Oral Contrast ◽  
C Reactive Protein ◽  
Cutoff Value ◽  
Reactive Protein ◽  
Cell Counts ◽  
Rule Out

Abstract   Anastomotic leakage is one of most severe complications after esophagectomy. There is no consensus on the best method of identification of such complications. Serum C-reactive protein measurement on postoperative day 5 (POD) has been reported to be reliable to rule-out leakage. Methods We prospectively assessed the medical records of consecutive post-esophagectomy patients from January 2019 to January 2020. We analyzed serum CRP and complete blood cell counts from the day before surgery to the POD5. A CRP level ≤ 150 mg/l at POD5 was considered sufficient to start oral feeding. In contrast a CRP level &gt; 150 mg/l at POD5 lead to a computed tomography (CT) with oral contrast to rule-out the presence of an anastomotic leakage. Anastomotic leakage was classified according to ECCG classification. Sensibility, sensitivity, positive and negative predictive value of CRP were calculated. Results Over a 12-month period, 52 patients were included (Figure 1). Measurement of CRP on POD5 was ≤150 mg/l in 34 (64%) patients (32 without fistula and 2 with fistula diagnosed after POD5) and &gt; 150 mg/L in 18 (36%) patients (8 without fistula and 10 with fistula). Twelve (23%) patients developed anastomotic fistula. The cutoff value of CRP ≤150 mg/l on the POD5 was associated with sensitivity 83%, specificity 80%, positive predictive value 56% and negative predictive value 94%. The CRP protocol allowed to avoid 30/52 (57%) unnecessary postoperative CT-scan. Conclusion On the basis of a high negative predictive value, a CRP level at POD5 ≤ 150 mg/l can be effective to eliminate an anastomotic leakage and to start oral feeding without any further exams. This information is useful in the context of ERAS protocols to reduce hospital discharge and decrease hospital costs.

scholarly journals Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal Metastasis

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2147
Author(s):  
Alba Fernández-Candela ◽  
Alicia Calero ◽  
Luís Sánchez-Guillén ◽  
Javier Escrig-Sos ◽  
José A. Barreras ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Peritoneal Carcinomatosis ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Major Morbidity ◽  
Factors Associated ◽  
Reactive Protein ◽  
Rule Out

The effect of preoperative immunonutrition intake on postoperative major complications in patients following cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) was assessed. The accuracy of C-Reactive Protein (CRP) for detecting postoperative complications was also analyzed. Patients treated within a peritoneal carcinomatosis program in which a complete or optimal cytoreduction was achieved were retrospectively analyzed. They were divided into two groups based on whether preoperative immunonutrition (IMN) or not (non-IMN) were administered. Clinical and surgical variables and postoperative complications were gathered. Predictive values of major morbidity of CRP during the first 3 postoperative days (POD) were also evaluated. A total of 107 patients were included, 48 belonging to the IMN group and 59 to the non-IMN group. In multivariate analysis immunonutrition (OR 0.247; 95%CI 0.071–0.859; p = 0.028), and the number of visceral resections (OR 1.947; 95%CI 1.086–3.488; p = 0.025) emerged as independent factors associated with postoperative major morbidity. CRP values above 103 mg/L yielded a negative predictive value of 84%. Preoperative intake of immunonutrition was associated with a decrease of postoperative major morbidity and might be recommended to patients with peritoneal carcinomatosis following CRS. Measuring CRP levels during the 3 first postoperative days is useful to rule out major morbidity.

Sign in / Sign up

Export Citation Format

Share Document