Value of C-reactive protein in reflecting the magnitude of complement activation in children undergoing open heart surgery

The kinetics of C-reactive protein (CRP) were studied prospectively in 30 children (aged 21 days – 16 years) undergoing open heart surgery. CRP was related to the kinetics of total haemolytic complement, complement C3a and postoperative complications. Two (7%) patients died and ten (33%) had postoperative complications. The patients with complications were younger (p<0.035), underwent longer perfusions (p<0.001) and had longer aortic cross-clamping times (p<0.003). The mean peak CRP level after surgery (108 mg/l) was reached, on the average, in 43 h. No statistical difference in CRP concentrations was found between the complication and non-complication groups. Extensive complement activation was seen in every patient. CRP did not reflect the magnitude of complement activation induced by cardiopulmonary bypass. The patient sample was too small to draw reliable conclusions about the value of CRP in detecting postoperative complications after open heart surgery in children.