HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Icard, P. Articles by Levasseur, P. Search for Related Content PubMed PubMed Citation Articles by Icard, P. Articles by Levasseur, P.

The Annals of Thoracic Surgery, Vol 57, 933-936, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Utility of C-reactive protein measurements for empyema diagnosis after pneumonectomy

P Icard, JP Fleury, JF Regnard, JM Libert, P Magdeleinat, N Gharbi, A Brachet, JF Levi and P Levasseur
Department of Surgery, Marie Lannelongue Surgical Center, Le Plessis Robinson, France.

Serum C-reactive protein (CRP) levels were studied serially during the postoperative period in 151 consecutive patients who underwent pneumonectomy. Virtually all patients who had a simple postoperative course (115 of 120), as well as 9 patients who had a bronchial infection of the remaining lung, 3 with a pulmonary embolus, and 2 who suffered postoperative bleeding requiring reoperation, demonstrated a similar postoperative evolution in their CRP values: a rapid postoperative rise until a peak or a plateau (mean peak value, 132 +/- 25 mg/L) was reached within 3 to 6 days, followed by a progressive decline to a value of less than 75 mg/L on day 9, and less than 50 mg/L on day 12. Conversely, all 12 patients who suffered empyema postoperatively, as well as 3 patients with bacterial pneumonia, 1 patient with chylothorax, and 1 patient with inflammatory pericarditis, demonstrated either a markedly persistent elevation in their CRP values or a secondary rise in the levels which exceeded 100 mg/L. Because of the high sensitivity (100%) and specificity (91.4%) of the CRP levels in detecting postpneumonectomy empyema, we recommend the routine use of this measure. Furthermore, a low CRP value after pneumonectomy (less than 50 mg/L) may help in deciding whether to confidently discharge a patient from the hospital in the absence of empyema. The negative predictive value of this method was found to be 100%.

This article has been cited by other articles:

				J D Chalmers, A Singanayagam, M P Murray, C Scally, A Fawzi, and A T Hill Risk factors for complicated parapneumonic effusion and empyema on presentation to hospital with community-acquired pneumonia Thorax, July 1, 2009; 64(7): 592 - 597. [Abstract] [Full Text] [PDF]

				D. Amar, H. Zhang, B. Park, P. M. Heerdt, M. Fleisher, and H. T. Thaler Inflammation and outcome after general thoracic surgery Eur. J. Cardiothorac. Surg., September 1, 2007; 32(3): 431 - 434. [Abstract] [Full Text] [PDF]

				M. Alifano, S. Sepulveda, A. Mulot, O. Schussler, and J.-F. Regnard A new method for detection of post-pneumonectomy broncho-pleural fistulas Ann. Thorac. Surg., May 1, 2003; 75(5): 1662 - 1664. [Abstract] [Full Text] [PDF]

				R. Gustafsson, P. Johnsson, L. Algotsson, S. Blomquist, and R. Ingemansson Vacuum-assisted closure therapy guided by C-reactive protein level in patients with deep sternal wound infection J. Thorac. Cardiovasc. Surg., May 1, 2002; 123(5): 895 - 900. [Abstract] [Full Text] [PDF]

				M. de Perrot and A. Spiliopoulos Postpneumonectomy bronchopleural fistula Ann. Thorac. Surg., November 1, 1999; 68(5): 1886 - 1887. [Full Text] [PDF]