Plasma concentrations of cytokines, their soluble receptors, and antioxidant vitamins can predict the development of multiple organ failure in patients at risk.
OBJECTIVE
The aims of this study were: a) to evaluate plasma concentrations of cytokines and their soluble receptors, as well as antioxidant substances in patients at high risk of developing multiple organ failure; b) to investigate early change: and c) to examine the possible prognostic value of these elements.


METHODS
Prospective analysis.


METHODS
Surgical intensive care unit (ICU) of a university hospital.


METHODS
sixteen patients at risk for multiple organ failure.


RESULTS
Ten patients developed multiple organ failure and five of them died. Whereas tumor necrosis factor-alpha (TNF-alpha) plasma concentrations were only borderline higher in patients developing multiple organ failure, TNF-soluble receptors 55 and 75 were significantly increased during all ICU days compared with patients not going into organ failure. Interleukin-6 plasma concentrations were higher in patients developing multiple organ failure during the first 2 days after ICU admission. The antioxidant vitamin C was significantly decreased in patients going into multiple organ failure during all ICU days. Other biochemical markers of antioxidant activity, such as vitamin E, copper, and zinc plasma concentrations, did not differ between the two groups.


CONCLUSIONS
Our data suggest that there is a marked increase in anti-TNF activity and a decrease of antioxidant defense in patients at risk of developing multiple organ failure. The predictive value of plasma concentrations of circulating TNF-soluble receptors and vitamin C in this type of patient needs further evaluation.
Borrelli
E
E
Division des Soins Intensifs Chirurgicaux, Hôpital Cantonal Universitaire, Genève, Switzerland.
Roux-Lombard
P
P
Grau
G E
GE
Girardin
E
E
Ricou
B
B
Dayer
J
J
Suter
P M
PM
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000975:Antioxidants / Q000032:analysis*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D018121:Receptors, Cytokine / Q000032:analysis*; D012307:Risk Factors; D012995:Solubility; D014815:Vitamins / Q000097:blood*
D000975:Antioxidants; D016207:Cytokines; D018121:Receptors, Cytokine; D014815:Vitamins