Effect of Therapeutic Hypothermia Treatment on Acute Phase Reactants

Z Geburtshilfe Neonatol. 2022 Oct;226(5):319-324. doi: 10.1055/a-1846-1545. Epub 2022 Aug 22.

Abstract

Objective: In our study, we aimed to examine the effect of therapeutic hypothermia treatment on C-reactive protein (CRP) and interleukin-6 (IL-6) in infants with hypoxic ischemic encephalopathy (HIE).

Methods: The data of the patients with the diagnosis of HIE we followed up in our unit between 2017 and 2018 were analyzed retrospectively. Patients who died during follow-up and patients with proven septicemia at the time of examination were excluded from the study. The routine CRP and IL-6 values ​​of the patients included in the study were compared before and after hypothermia treatment.

Results: Therapeutic hypothermia treatment applied for 72 hours was found to cause a statistically significant increase in CRP after treatment when compared with the values ​​measured before treatment (0.6 (0.2-1.9) before and median (P25-75), and after treatment 7.5 (4-18) and median (P25-75) mg/L, p=0.00). While IL-6 was found to be high in the early period due to the effect of hypoxia, it was found to be low after hypothermia treatment (80.5 (40-200) median (P25-75) - 32 (18-50) median (P25-75) pg/ml, p=0.131). While the white blood cell count was high before hypothermia treatment due to hypoxia, it was found to be low after treatment (24600 (19600-30100) median (P25-75) -11300 (8800-14200) median (P25-75)/µL, p=0.001).

Conclusion: White blood cells and IL-6 can be found to be high due to hypoxia without infection, and CRP can be found to be high after therapeutic hypothermia treatment without infection. The effect of hypoxia and hypothermia should be considered when evaluating acute phase reactants.

MeSH terms

  • Acute-Phase Proteins
  • C-Reactive Protein / analysis
  • Humans
  • Hypothermia*
  • Hypothermia, Induced*
  • Hypoxia-Ischemia, Brain* / diagnosis
  • Hypoxia-Ischemia, Brain* / therapy
  • Infant
  • Interleukin-6
  • Retrospective Studies

Substances

  • Acute-Phase Proteins
  • Interleukin-6
  • C-Reactive Protein