C-Reactive protein-determined injury severity: Length of stay predictor in surgical infants

Serum C-reactive protein (CRP) levels reflect the severity of the metabolic response to injury in critically ill children. During this period, caloric overfeeding can increase complications and delay recovery. The authors hypothesized that by avoiding excessive caloric delivery, the effect of injury...

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Bibliographic Details
Published in:Journal of pediatric surgery 2004-12, Vol.39 (12), p.1832-1834
Main Authors: Alaedeen, Diya I., Queen, Aaric L., Leung, Eric, Liu, Donald, Chwals, Walter J.
Format: Article
Language:English
Subjects:
C-reactive protein
C-Reactive Protein - analysis
critically ill infants
energy expenditure
Female
Humans
indirect calorimetry
Infant
injury severity
length of stay
Length of Stay - statistics & numerical data
Male
overfeeding
Predictive Value of Tests
Severity of Illness Index
Surgical Procedures, Operative - adverse effects
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Summary:Serum C-reactive protein (CRP) levels reflect the severity of the metabolic response to injury in critically ill children. During this period, caloric overfeeding can increase complications and delay recovery. The authors hypothesized that by avoiding excessive caloric delivery, the effect of injury severity would be the major factor determining clinical outcome. Twenty-eight surgical infants who had indirect calorimetry measurements while in the Neonatal Intensive Care Unit between August 2000 and January 2002 were studied. Serum CRP concentrations, mean energy expenditure (MEE), respiratory quotient (RQ), length of hospital stay (LOS), and caloric intake (I) at the time of indirect calorimetry were recorded. Data were analyzed using the Pearson product-moment correlation. Peak serum CRP was significantly correlated to LOS in all patients (r = 0.79, P < .0001). When net caloric balance (I-MEE) did not exceed 5 kcal/kg/d (n = 9), peak serum CRP was correlated positively with RQ (r = 0.66, P = .05). When I-MEE exceeded 5 kcal/kg/d (n = 19), the positive correlation of serum CRP with RQ was diminished (r = 0.23, P = .33). CRP-measured injury severity is a major determinant of clinical outcome in surgical infants. In addition, overfeeding causes additional RQ elevation.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2004.08.002