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Association between C-reactive protein levels and outcome in acute lung injury in children

M Bruijn1, E M Jansen, T Klapwijk

  • 1Pediatric Intensive Care Unit, Emma Children's Hospital/Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands. m.bruijn@amc.nl

European Journal of Pediatrics
|May 4, 2013
PubMed

Insights

In children with acute lung injury (ALI), high C-reactive protein (CRP) levels do not predict a favorable outcome, unlike in adults. This study examined CRP

Area of Science:

  • Pediatric critical care medicine
  • Inflammatory biomarkers
  • Acute Lung Injury (ALI) research

Background:

  • High plasma C-reactive protein (CRP) levels are linked to better outcomes in adult acute lung injury (ALI).
  • The relationship between CRP levels and outcomes in pediatric ALI is not well-established.
  • Understanding prognostic markers in pediatric ALI is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the association between plasma C-reactive protein (CRP) levels and clinical outcomes in children with acute lung injury (ALI).
  • To compare findings in pediatric ALI with existing data from adult ALI populations.

Main Methods:

  • A historical cohort study was conducted on 93 mechanically ventilated children (0-18 years) diagnosed with ALI.
  • Plasma CRP levels were measured within 48 hours of ALI onset and correlated with 28-day mortality and ventilator-free days (VFD).
  • Statistical analyses, including logistic regression, were used to assess the association between CRP levels and outcomes, adjusting for potential confounders like cardiovascular organ failure.

Main Results:

  • Non-survivors had significantly higher median CRP levels (126 mg/L) compared to survivors (56 mg/L) (p=0.01).
  • Unadjusted analysis showed an 8.7% increase in mortality odds for every 10-mg/L rise in CRP.
  • After adjusting for cardiovascular organ failure, this association was no longer statistically significant (p=0.22).
  • Increased CRP levels were significantly associated with fewer ventilator-free days (VFD) (ρ = -0.26, p = 0.01).

Conclusions:

  • Unlike in adults, elevated plasma CRP levels are not associated with a favorable outcome in pediatric patients with ALI.
  • Cardiovascular organ failure emerged as a stronger predictor of mortality in this pediatric cohort.
  • Further research is needed to elucidate the role of inflammatory markers in pediatric ALI prognosis.
Abstract

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