Presenter Status

Fellow

Abstract Type

Research

Primary Mentor

Venkatesh Sampath, MD

Start Date

11-5-2021 11:30 AM

End Date

11-5-2021 1:30 PM

Presentation Type

Poster Presentation

Description

Background: C-reactive protein (CRP) is an inflammatory marker that has been recognized as a biomarker of the systemic inflammatory response in preterm neonates. We hypothesized that initial and peak CRP values would correlate with the degree of sepsis-induced acute lung injury (ALI) as measured by the pulmonary severity score (PSS).

Objectives/Goal: 1) Determine if confirmed (CF) sepsis events are associated with higher initial and peak CRP values than rule out (RO) sepsis events. 2) Investigate if initial and/or peak CRP correlates with severity of sepsis-induced ALI as measured by the PSS.

Methods/Design: In this retrospective case control study, we included infants < 31 weeks gestational age and < 1500 grams with late onset sepsis and RO sepsis events (blood culture negative, antibiotics continued 48-72 hours (hr)). We collected initial CRP values at the time of sepsis diagnosis and the peak CRP value recorded during the treatment period. Sepsis subtypes were defined as blood culture positive (Cx+), necrotizing enterocolitis (NEC), urinary tract infection (UTI), and culture negative (Cx-) sepsis (blood culture negative; antibiotics > 6 days). We collected the PSS, a validated score for lung injury, at different time points during the sepsis events starting at 72hr before and up to 168hr after sepsis diagnosis.

Results: We analyzed 211 CF and 123 RO sepsis events. Initial and peak CRP values were significantly higher in the CF sepsis group vs the RO sepsis group [median and interquartile range 1.8 (0.7, 4.5) vs. 0.6 (0.5-1.1), p

Conclusions: These results indicate that CRP is significantly higher both initially and at peak values in infants with CF vs RO sepsis events. Furthermore, CRP values correlate with PSS over time suggesting that CRP is not only a marker for sepsis/systemic inflammatory response but can potentially predict the severity of sepsis-induced ALI.

MeSH Keywords

infant, premature; sepsis; acute lung injury; c-reactive protein

Additional Files

C-reactive protein values to predict sepsis-induced inflammatory.pdf (208 kB)
Abstract

CRP and PSS Figure 1.png (101 kB)
Figure 1 - Initial and peak (maximal) CRP values in confirmed and rule out sepsis episodes

CRP and PSS Figure 2.png (36 kB)
Figure 2 - Initial and peak (maximal) CRP trajectories between confirmed and rule out sepsis

CRP and PSS Figure 3.png (103 kB)
Figure 3 - Predicted PSS vs initial and max CRP at various time points

CRP and PSS Figure 4.png (45 kB)
Figure 4 - Initial vs max CRP values across sepsis subtypes

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May 11th, 11:30 AM May 11th, 1:30 PM

C-reactive protein values to predict sepsis-induced inflammatory response in premature infants

Background: C-reactive protein (CRP) is an inflammatory marker that has been recognized as a biomarker of the systemic inflammatory response in preterm neonates. We hypothesized that initial and peak CRP values would correlate with the degree of sepsis-induced acute lung injury (ALI) as measured by the pulmonary severity score (PSS).

Objectives/Goal: 1) Determine if confirmed (CF) sepsis events are associated with higher initial and peak CRP values than rule out (RO) sepsis events. 2) Investigate if initial and/or peak CRP correlates with severity of sepsis-induced ALI as measured by the PSS.

Methods/Design: In this retrospective case control study, we included infants < 31 weeks gestational age and < 1500 grams with late onset sepsis and RO sepsis events (blood culture negative, antibiotics continued 48-72 hours (hr)). We collected initial CRP values at the time of sepsis diagnosis and the peak CRP value recorded during the treatment period. Sepsis subtypes were defined as blood culture positive (Cx+), necrotizing enterocolitis (NEC), urinary tract infection (UTI), and culture negative (Cx-) sepsis (blood culture negative; antibiotics > 6 days). We collected the PSS, a validated score for lung injury, at different time points during the sepsis events starting at 72hr before and up to 168hr after sepsis diagnosis.

Results: We analyzed 211 CF and 123 RO sepsis events. Initial and peak CRP values were significantly higher in the CF sepsis group vs the RO sepsis group [median and interquartile range 1.8 (0.7, 4.5) vs. 0.6 (0.5-1.1), p

Conclusions: These results indicate that CRP is significantly higher both initially and at peak values in infants with CF vs RO sepsis events. Furthermore, CRP values correlate with PSS over time suggesting that CRP is not only a marker for sepsis/systemic inflammatory response but can potentially predict the severity of sepsis-induced ALI.