C-reactive protein in the diagnosis, management, and prognosis of neonatal necrotizing enterocolitis.

Abstract:

OBJECTIVE:In this prospective, observational study, we determined whether serum C-reactive protein (CRP) correlated with necrotizing enterocolitis (NEC) stages II and III. We hypothesized that serial CRP measurement if used as an adjunct to abdominal radiographs would improve the identification of infants with NEC. METHODS:Serum CRP level was measured every 12 hours for 3 measurements and, when abnormal, once daily. When clinical signs persisted and the initial abdominal radiographs were abnormal, follow-up radiographs were obtained. RESULTS:Of 241 infants who were evaluated for gastrointestinal signs, 11 had ileus or benign pneumatosis intestinalis with persistently normal CRP; gastrointestinal manifestations resolved within 48 hours, antibiotics were discontinued in <48 hours, and feedings were restarted early without complications. Fifty-five infants had NEC stages II and III; all had abnormal CRP regardless of their blood culture results. In infants with stage II NEC, CRP returned to normal at a mean of 9 days except in those who developed complications such as stricture or abscess formation. CONCLUSIONS:In infants with suspected NEC, normal serial CRP values would favor aborted antibiotic therapy and early resumption of feedings. CRP becomes abnormal in both stage II and stage III NEC. In infants with NEC, persistently elevated CRP after initiation of appropriate medical management suggests associated complications, which may require surgical intervention.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Pourcyrous M,Korones SB,Yang W,Boulden TF,Bada HS

doi

10.1542/peds.2004-1806

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

1064-9

issue

5

eissn

0031-4005

issn

1098-4275

pii

116/5/1064

journal_volume

116

pub_type

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