Studies Types of patients included Conclusions Remarks Ugarte et al. [18 ] 180 patients with
and without infections
. Best cut-off value Exclusion of surgical patients Reny et al. [19 ] 74 patients with 28 with proven infection Higher CRP concentrations in infected patients (i) No cut-off value for CRP Póvoa et al. [20 ] Subgroup of patients with VAP
Higher CRP levels in patients with VAP than in noninfected patients. No CRP comparisons between patients with VAP and other infections
Póvoa et al. [21 ] Patients with a length of stay ≥3 days A maximum daily variation of 4.1 mg/dL is a good marker of infection Long delay between positive culture and start of antibiotics Lobo et al. [22 ] 303 patients with a length of stay ≥2 days (i) High CRP at admission was associated with higher risk of infection Results only applicable if CRP at admission is >10 mg/dL Castelli et al. [23 ] 255 patients (111 septic, 49 trauma, 45 with, and 50 without SIRS) (i) Cut-off for infection: 128 mg/L Maximum CRP with a delay of 24 or 48 hours Silvestre et al. [24 ] 158 ICU patients No relationship between CRP at ICU admission and infection and mortality No relationship between CRP and presence of a microorganism Póvoa et al. [25 ] 891 patients admitted in ICU with diagnosis of community-acquired sepsis. (i) No difference in CRP at ICU admission between survivors or nonsurvivors Same evolution for SOFA score but not for fever or leukocyte count Vandijck et al. [26 ] 84 ICU patients with nosocomial bacteremia Higher values of CRP with Gram-negative bacilli compared to Gram-positive cocci bacteremia Review of the time course of CRP before the bacteremia Póvoa et al. [27 ] 44 ICU patients with bacteremia CRP concentrations ratio start to change only at day 2 in survivors. CRP ratio only predictive of outcome at day 4 Zhang and Ni [28 ] Meta-analysis of 14 studies including 1969 patients Evolution of CRP for more than 48 hours is predictive of outcome Large heterogeneity of the studies (
= 92%) Póvoa et al. [29 ] 186 septic cancer patients with
or without
neutropenia (i) CRP concentrations were higher in neutropenic patients Same evolution of CRP between neutropenic and nonneutropenic patients Fraunberger et al. [30 ] 38 ICU patients at the onset of fever (i) Increase in CRP at the onset of fever Comparisons of CRP between ICU patients and volunteers Su et al. [31 ] 144 ICU patients at the onset of fever (84 sepsis and 64 SIRS) (i) CRP more elevated in septic compared to patients with SIRS CRP concentrations were lower in patients with bacteremia Christ-Crain et al. [32 ] 50 infected patients with
or without appropriate antibiotics
or peritonitis
An increase in CRP of at least 2.2 mg/dL in the first 48 h was associated with ineffective initial antibiotic therapy (i) Only 8 patients with peritonitis Bota et al. [33 ] 864 patients with
and without cirrhosis
(i) CRP levels were higher in cirrhotic with infection compared to cirrhotic patients without infection. No data about CRP levels in relation with the severity of sepsis (SOFA, vasopressor dosage, PaO2 /FiO2 , extra renal replacement) for each level of cirrhosis Silvestre et al. [34 ] 7 patients with hepatic failure Low CRP levels in patients with infection Few patients included. One with a diagnosis of hepatic failure at ICU day 26
