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Multicenter Study
. 2022 Oct-Dec;25(4):498-504.
doi: 10.4103/aca.aca_141_21.

C-Reactive protein kinetics after cardiac surgery: A retrospective multicenter study

Cristina Santonocito  1 , Filippo Sanfilippo  1 , Isabelle De Locker  2 , Federica Chiarenza  1 , Cucuzza Giacomo  1 , Hassane Njimi  2 , Shane George  3 , Marinella Astuto  4 , Jean-Louis Vincent  2
Affiliations
Multicenter Study

C-Reactive protein kinetics after cardiac surgery: A retrospective multicenter study

Cristina Santonocito et al. Ann Card Anaesth. 2022 Oct-Dec.

Abstract

Background: Recognition of postoperative infection after cardiac surgery is challenging. Biomarkers may be very useful to recognize infection at early stage, but the literature is controversial.

Methods: We conducted a retrospective study at two large University Hospitals, including adult patients undergoing cardiac surgery (excluding those with preoperative infections, cirrhotic or immunocompromised). We evaluated the kinetics of C-Reactive Protein (CRP) and White Cell Count (WCC) during the first postoperative week. Primary outcomes were CRP and WCC changes according to the development of postoperative infection. In order to evaluate the influence of cardiopulmonary bypass on biomarker kinetics, we also studied CRP and WCC changes in patients without postoperative infection and undergoing on- vs off-pump coronary-artery bypass grafting.

Results: Among 429 included, 45 patients (10.5%) had evidence of postoperative infection. Patients with postoperative infection had higher CRP and WCC values than those without infection, with between-groups difference becoming significant from postoperative day 2 for CRP (120.6 ± 3.6 vs. 134.6 ± 7.9, P < 0.01), and from postoperative day 3 for WCC (10.5 ± 0.5 vs. 9.9 ± 0.2, P = 0.02). Over the postoperative period, CRP and WCC showed significant within-group changes regardless of development of postoperative infection (P < 0.001 for both). We found no differences in CRP and WCC kinetics between patients undergoing on- vs off-pump procedure.

Conclusions: During the first week after cardiac surgery, CRP increases one day earlier than WCC in patients developing postoperative infections, with such difference becoming significant on the second postoperative day. In not infected patients, use of cardiopulmonary bypass does not influence CRP and WCC kinetics.

Keywords: Biomarkers; cardiac surgery; infection.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
C-Reactive Protein (CRP) kinetics after cardiac surgery comparing patients with or without postoperative infection. POD: Postoperative day. SE: Standard error
Figure 2
Figure 2
White Cell Count (WCC) kinetics after cardiac surgery comparing patients with or without postoperative infection. POD: Postoperative day. SE: Standard error
See this image and copyright information in PMC

References

    1. Calandra T, Cohen J. The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Crit Care Med. 2005;33:1538–48. - PubMed
    1. Corral L, Carrió ML, Ventura JL, Torrado H, Javierre C, Rodriguez-Castro D, et al. Is C-reactive protein a biomarker for immediate clinical outcome after cardiac surgery? J Cardiothorac Vasc Anesth. 2009;23:166–9. - PubMed
    1. Davidson J, Tong S, Hauck A, Lawson DS, da Cruz E, Kaufman J. Kinetics of procalcitonin and C-reactive protein and the relationship to postoperative infection in young infants undergoing cardiovascular surgery. Pediatr Res. 2013;74:413–9. - PMC - PubMed
    1. Vincent JL, Donadello K, Schmit X. Biomarkers in the critically ill patient: C-reactive protein. Crit Care Clin. 2011;27:241–51. - PubMed
    1. Delannoy B, Guye ML, Slaiman DH, Lehot JJ, Cannesson M. Effect of cardiopulmonary bypass on activated partial thromboplastin time waveform analysis, serum procalcitonin and C-reactive protein concentrations. Crit Care. 2009;13:R180. - PMC - PubMed

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