C Reactive protein and disease severity in bronchiolitis

Costa, Sueli I. R.; Rocha, Raquel; Tavares, Marcelo de Sousa; Bonito-Vítor, A.; Guedes-Vaz, L.; João, Hospital S.

doi:10.1016/s2173-5115(09)70088-0

Cited by 9 publications

(8 citation statements)

References 8 publications

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“…Concerning bronchiolitis, Costa et al evaluated the correlation between CRP values and the disease severity in 176 infants. Similar to our observations, they found a significant relationship between higher levels of CRP with PICU admission rate and LOS hospitalization 20 . Although the traditional inflammatory markers are thought to have limited value to assess the severity of bronchiolitis, we have shown that increased levels of CRP may reflect an increased inflammatory state independent of the occurrence of bacterial superinfection, as opposed to procalcitonin.…”

Section: Discussionsupporting

confidence: 90%

Routine laboratory test to assess the need of respiratory support in acute bronchiolitis

Rodríguez-González

Estepa-Pedregosa

Estalella-Mendoza

et al. 2022

Pediatric Pulmonology

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Background and Objectives: Accurate and readily available biomarkers to predict the clinical course of bronchiolitis would enable enhanced decision-making in this setting. We explored the relationship of several biochemical parameters available at the pediatric emergency care setting with the need of advanced respiratory support (ARS): continuous positive airway pressure (CPAP), biphasic positive airway pressure (BiPAP), or invasive mechanical ventilation (MV) in bronchiolitis.Methods: Single-center, prospective, observational, including infants aged less than 12 months diagnosed with acute bronchiolitis at the Pediatric Emergency Department. Determination of plasmatic values of several laboratory tests was performed at the time of hospital admission. Multivariate logistic analysis identified independent predictors for need of ARS.Results: From October 1, 2018 to May 1, 2020, we recruited 149 infants (58% males; median age of 1 [0.5-2.5] month). Thirty-seven (25%) cases required ARS.After adjusting by age, bacterial superinfection, and comorbidities in the multivariate analysis, only higher levels of glycemia (p = 0.001), C-reactive protein (CRP) (p = 0.028), CRP/albumin ratio (p = 0.032), and NT-proBNP (p = 0.001) remained independently associated with ARS. These biomarkers reached moderate prediction accuracy with area under the curve of receiver operator curve curves ranging from 0.701 to 0.830 (p = 0.001). All they presented relatively high specificity (0.75-0.84) and negative predictive values (0.77-0.89) with low sensitivity and positive predictive values. They also correlated significantly with length of stay hospitalization (p = 0.001). Conclusion:Increased plasmatic levels of CRP, CRP/albumin ratio, glycemia, and NT-proBNP at hospital admission are associated with the need for ARS in infants with acute bronchiolitis.

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Section: Discussionsupporting

confidence: 90%

Routine laboratory test to assess the need of respiratory support in acute bronchiolitis

Rodríguez-González

Estepa-Pedregosa

Estalella-Mendoza

et al. 2022

Pediatric Pulmonology

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“…Hyponatremia (blood sodium levels <135 mmol/L) is common among patients with respiratory infections, and was associated with higher severity of disease in children with bronchiolitis admitted to the Pediatric Intensive Care Unit (PICU) [13]. Additionally, children with higher C-Reactive Protein (CRP) values had higher admission rates to the PICU, longer LOS and higher duration of need for supplemental oxygen [14].…”

Section: Introductionmentioning

confidence: 99%

Factors predicting length of stay in bronchiolitis

Masarweh

Gur

Leiba

et al. 2020

Respiratory Medicine

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“…The study conducted by Kaur et al [19], Costa et al [20], and Fares et al [21] concluded that CRP was increased in cases of bacterial co-infection and is helpful in deciding the initiation of antibiotics and also predicting the disease severity. Similarly, in the present study, 1 child in control group and 2 in MgSO 4 group received intravenous antibiotics for suspected bacterial infection as they had high C-reactive protein (CRP) associated with bilateral infiltrates on chest radiograph, high grade fever and severe respiratory distress.…”

Section: Discussionmentioning

confidence: 99%

Nebulized Magnesium Sulphate in Bronchiolitis: A Randomized Controlled Trial

et al. 2021

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Objective To evaluate the efficacy and safety of nebulized magnesium sulphate as a bronchodilator in young children aged 1-24 mo with moderate to severe bronchiolitis in comparison to standard therapy. Methods This was an open labeled randomized controlled trial comprising 60 children with moderate to severe bronchiolitis which was randomly assigned to 2 groups. Intervention group received nebulization with 3 mL of 3.2% magnesium sulphate (MgSO 4 ) (iso-osmolar) every 4 hourly for 24 h in addition to standard care and the control group received standard care alone. The primary outcome measure was to compare the improvement of bronchiolitis severity score (BSS) and length of hospitalization. The secondary outcome was to measure the need for noninvasive ventilation, need for admission to intensive care unit (ICU) in the initial visit, to evaluate the safety of magnesium sulphate and need for clinic revisit, hospital readmission and ICU readmission within 2 wk after discharge in both the groups. Results The mean age of children allocated in the control group was 7.4 ± 5.1 mo and 7.7 ± 4.5 mo in the intervention group. There was no significant difference with respect to improvement of BSS or reduced length of hospitalization in both the groups (p > 0.05). BSS monitored sequentially after enrollment at 1, 2, 4, 8, 12, 16, and 24 h did not show statistically significant differences between the groups. Mean length of hospital stay was 2.89 ± 2.25 d in treatment group and 2.96 ± 1.86 d in control group (p = 0.902). No adverse events were observed in both the groups. Conclusion Nebulized magnesium sulphate is not superior to standard therapy in children with moderate to severe bronchiolitis.

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C Reactive protein and disease severity in bronchiolitis

Cited by 9 publications

References 8 publications

Routine laboratory test to assess the need of respiratory support in acute bronchiolitis

Routine laboratory test to assess the need of respiratory support in acute bronchiolitis

Factors predicting length of stay in bronchiolitis

Nebulized Magnesium Sulphate in Bronchiolitis: A Randomized Controlled Trial

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