title: Plasma tumor necrosis factor and mortality in critically ill septic patients.
abstract: Tumor necrosis factor (TNF) cachectin has been implicated as an important host mediator responsible for shock and multiple organ failure (MOF) observed during sepsis. Using a sensitive enzyme-linked immunosorbent assay, we measured plasma TNF levels in 43 septic patients suffering from a broad range of diseases. Measurements were taken on the day that sepsis was diagnosed. Eleven patients had detectable TNF plasma levels ranging from 10 to 100 pg/ml (TNF-positive group); in 32 patients circulating TNF could not be detected (TNF-negative group). The groups did not differ significantly as to age, underlying disease, percentage positive bacteremia and bacteriologic profile, sepsis score, and extent of MOF. Eight (73%) of 11 TNF-positive patients died from sepsis during ICU stay, vs. 11 (34%) of 32 TNF-negative patients (p less than .05). This study demonstrates that sepsis is accompanied by detectable circulating TNF in 25% of the cases, and for these patients mortality is twice that for comparable TNF-negative patients.
authors.affiliation: Department of General Surgery, University of Limburg, Maastricht, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Debets
authors.forename: R
authors.initials: R
authors.lastname: Kampmeijer
authors.forename: M P
authors.initials: MP
authors.lastname: van der Linden
authors.forename: W A
authors.initials: WA
authors.lastname: Buurman
authors.forename: C J
authors.initials: CJ
authors.lastname: van der Linden
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000097:blood* / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D014409:Tumor Necrosis Factor-alpha