Evaluation of the C-reactive Protein/Albumin Ratio and Fluid Overload in Critically Ill Children and Adolescents Aged One Month to 18 Years

Introduction The pediatric intensive care unit (PICU) is a specialized area for treating critically ill infants and children. However, some of these children may experience poor outcomes, including death. However, it is necessary to predict the prognosis for critically ill patients as early as possible to commence triage as well as an early and effective intervention to prevent mortality. The objective was to evaluate C-reactive protein (CRP) to albumin ratio and fluid overload as predictors of mortality in critically ill children and adolescents (one month to 18 years). Methodology This was a prospective, observational study conducted on 100 critically ill cases admitted to the PICU in a tertiary care hospital. Demographic profiles and clinical manifestations were noted, and baseline investigations were carried out. Children were provided treatment according to PICU protocols. CRP and serum albumin levels were measured, and fluid intake and output were documented in detail. Results The mean CRP/albumin ratio in the survivor group was 16.39±14.161, while in the non-survivor group, it was reported to be 12.95±11.905. The mean CRP/albumin ratio among the patients who required ventilation for <3 days, 3-5 days, and >5 days were 16.91±14.35, 12.90±10.80, and 2.0±0.321, respectively. The mean value for fluid overload in the survivor group was 10.90±7.44 and in the non-survivor group was 20.54±18.727. The mean fluid overload among the patients who required ventilation for <3 days, 3-5 days, and >5 days were 14.61±9.639, 19.30±13.21, and 20.74±19.81, respectively. CRP/albumin ratio was directly related to increased ventilation in critically ill patients, inversely proportional to ventilatory stay. Fluid overload was directly associated with the development of multiple organ dysfunction syndrome (MODS). Conclusion It was concluded that fluid overload can be used as a predictor of poor outcome though CRP/albumin ratio still warrants further studies.