C-reactive protein is not a useful indicator for infection in surgical intensive care units.
OBJECTIVE
C-reactive protein (CRP) is commonly used as a marker for inflammatory states and for early identification of infection. This study aimed to investigate CRP as a marker for infection in patients with postoperative septic shock.


METHODS
Prospective, single-center study, developed in a surgical intensive care unit at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo.


METHODS
This study evaluated 54 patients in the postoperative period, of whom 29 had septic shock (SS group) and 25 had systemic inflammatory response syndrome (SIRS group). All of the patients were monitored over a seven-day period using the Sequential Organ Failure Assessment (SOFA) score and daily CRP and lactate measurements.


RESULTS
The daily CRP measurements did not differ between the groups. There was no correlation between CRP and lactate levels and the SOFA score in the groups. We observed that the plasma CRP concentrations were high in almost all of the patients. The patients presented an inflammatory state postoperatively in response to surgical aggression. This could explain the elevated CRP measurements, regardless of whether the patient was infected or not.


CONCLUSIONS
This study did not show any correlation between CRP and infection among patients with SIRS and septic shock during the early postoperative period.
Cicarelli
Domingos Dias
DD
Department of Surgery, Hospital das Clínicas da Faculdade, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. dcicarelli@uol.com.br
Vieira
Joaquim Edson
JE
Benseñor
Fábio Ely Martins
FE
D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003422:Critical Care; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies; D012772:Shock, Septic / Q000097:blood / Q000175:diagnosis*; D013530:Surgical Wound Infection / Q000150:complications; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis*
D015415:Biomarkers; D019344:Lactic Acid; D002097:C-Reactive Protein