title: C-reactive protein levels after cardiac arrest in patients treated with therapeutic hypothermia.
abstract: Prognostication of outcome after cardiac arrest (CA) is challenging. We assessed the prognostic value of daily blood levels of C-reactive protein (CRP), a cheap and widely available inflammatory biomarker, after CA.
  
  
  
  We reviewed the data of all patients admitted to our intensive care unit (ICU) after CA between January 2009 and December 2011 and who survived for at least 24h. We collected demographic data, CA characteristics (initial rhythm; location of arrest; time to return of spontaneous circulation [ROSC]), occurrence of infection, ICU survival and neurological outcome at three months (good=cerebral performance category [CPC] 1-2; poor=CPC 3-5). CRP levels were measured daily from admission to day 3.
  
  
  
  A total of 130 patients were admitted after successful resuscitation from CA and survived more than 24h; 76 patients (58%) developed an infection and overall mortality was 56%. CRP levels increased from admission to day 3. CRP levels were higher in in-hospital than in out-of-hospital CA, especially on admission and day 1 (44.1 vs. 2.1 mgL(-1) and 74.5 vs. 29.5 mgL(-1), respectively; p<0.001), and in patients with non-shockable than in those with shockable rhythms. In a logistic regression model, high CRP levels on admission were independently associated with poor neurological outcome at 3 months.
  
  
  
  CRP levels increase in the days following successful resuscitation of CA. Higher CRP levels in patients with in-hospital CA, non-shockable rhythms and infection, suggest a greater inflammatory response in these patients. High CRP levels on admission may identify patients at high-risk of poor outcome and could be a target for future therapies.
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium.
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Dell'anna
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium.
authors.forename: Julia
authors.initials: J
authors.lastname: Bini Viotti
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Beumier
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium.
authors.forename: Diego
authors.initials: D
authors.lastname: Orbegozo-Cortes
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium.
authors.forename: Katia
authors.initials: K
authors.lastname: Donadello
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium.
authors.forename: Sabino
authors.initials: S
authors.lastname: Scolletta
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium. Electronic address: ftaccone@ulb.ac.be.
authors.forename: Fabio Silvio
authors.initials: FS
authors.lastname: Taccone
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000097:blood* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000379:methods*; D007239:Infections / Q000209:etiology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Biomarker; Cardiac arrest; Infection; Inflammation; Prognosis