Effect of therapeutic hypothermia on C-reactive protein levels in patients with perinatal asphyxia

Am J Perinatol. 2015 Jun;32(7):667-74. doi: 10.1055/s-0034-1393933. Epub 2014 Nov 7.

Abstract

Objective: To determine the changes in serum C-reactive protein (CRP) levels during therapeutic hypothermia.

Study design: Between January 2011 and June 2013, 133 hypoxic-ischemic encephalopathy patients being followed up in the neonatal intensive care unit of Dr. Sami Ulus Maternity and Children's Hospital are prospectively evaluated. Group 1; patients that received therapeutic hypothermia (n = 74) and group 2; patients that did not required therapeutic hypothermia (n = 59). All the patients underwent serial complete blood cell count and CRP assessments; blood cultures were obtained from all the cases at the time of admission and when CRP levels were elevated.

Results: Positive blood cultures were encountered in five cases (6.7%) in group 1 while no blood culture-proven septicemia was encountered in group 2. The CRP levels elevated gradually reaching a peak level on the 4th day and then decreased during the therapeutic hypothermia in patients with no blood culture-proven septicemia in group 1. The CRP levels showed statistically significant changes reaching a peak level on the 7th day in patients with blood culture-proven septicemia in group 2. Also, the CRP levels showed no alteration with time in group 2.

Conclusion: Therapeutic hypothermia itself might be associated with CRP elevation rather than an actual infection.

MeSH terms

  • Area Under Curve
  • Asphyxia Neonatorum / blood*
  • Asphyxia Neonatorum / complications
  • C-Reactive Protein / metabolism*
  • Female
  • Humans
  • Hypothermia, Induced*
  • Hypoxia-Ischemia, Brain / blood*
  • Hypoxia-Ischemia, Brain / etiology
  • Hypoxia-Ischemia, Brain / therapy*
  • Infant, Newborn
  • Male
  • Perinatal Care
  • Prospective Studies
  • ROC Curve
  • Sepsis / blood*
  • Time Factors

Substances

  • C-Reactive Protein