Predictive value of C-reactive protein in critically ill patients who develop acute lung injury

BackgroundAcute lung injury (ALI) is associated with significant mortality and morbidity. C-reactive protein (CRP) level a marker of systematic inflammation is widely-used in numerous clinical conditions, however little is known about the characteristics of CRP levels in patients with ARDS and acute lung injury (ALI).The aim of this work was to examine the plasma level of C-reactive protein (CRP) in patients with acute lung injury (ALI) and its relationship with prognosis, outcome, and severity of illness.Patients and methodsThe study was carried out on 100 consecutive patients, who were admitted to the Critical Care Medicine Departments in Alexandria Main University Hospital. Inclusion criteria were patients were aged >18 years who had one or more of the acute lung injury (ALI) predisposing conditions. Patients who developed ALI based on standard definition according to the American–European consensus conference were examined for C-reactive protein levels measured in serum (mg/dl) collected within 48 h after fulfillment of criteria.ResultsCRP levels were the highest in patients with complete recovery ranging between 190 and 233 mg/dl with a mean of 211.5 ± 30.406 mg/dl, modest in patients who recovered with residual complications ranging between 107 and 120 with a mean of 111.33 ± 7.506 mg/dl, and lowest in patients who died ranging between 35 and 106 with a mean of 79.55 ± 24.007 mg/dl. Higher CRP levels were significantly associated with better survival (P = 0.000). There was an inverse relationship between CRP levels and duration of mechanical ventilation while ICU stay increased as the CRP levels increased. The relationships between CRP levels and both mechanical ventilation days and ICU stay were statistically non significant (P = 0.710 and 0.801 respectively). CRP levels were lower in patients who developed multiorgan dysfunction syndrome (MODS) with a mean of 76.6 ± 28.778 mg/dl compared to a mean of 111.43 ± 59.332 mg/dl in patients who didn’t develop MODS, this relationship was not statistically significant (P = 0.060).ConclusionsAlthough CRP has widely been considered to be a marker of systemic inflammation, our findings show that higher levels of CRP are associated with decreased mortality, organ failure, and need for mechanical ventilation among patients with ALI.