[Importance of determination of proinflammatory cytokines in the blood of polytraumatized patients with sepsis].
Severe sepsis and trauma complicated with multiple organ dysfunction syndrome (MODS) are among the leading causes of death in intensive therapy units, with mortality rate exceeding 50%. The outcome is not determined only by infection or trauma, but also by the intensity of immuno-inflammatory response, which is essential for host defence, but if uncontrolled leads to MODS. Pro-inflammatory cytokines (tumor necrosis factor-alpha--TNF-alpha, IL-1, IL-8, IL-12, IFN-gamma, etc.) represent a part of this immuno-inflammatory response to an insult. The results of the clinical investigation of correlation between pro-inflammatory cytokines (IL-8, IL-12, TNF-alpha, IFN-gamma), the outcome (survivors, non-survivors), and the severity (systemic inflammatory response syndrome--SIRS--less severe, and MODS--more severe) in polytraumatised patients with sepsis are presented in this paper. Mean values of IL-8 were 1.3-fold higher in non-survivors (p<0.05), and 60-fold higher in MODS group (p<0.01). Mean values of IL-12 were 1.6-fold higher in survivors (p<0.01), while the values between SIRS and MODS group did not differ significantly; mean values of TNF-alpha were 3-fold higher in survivors (p<0.05), and 46-fold higher in MODS group (p<0.01). Mean values of IFN-gamma did not differ significantly between the two groups regarding the outcome and severity. The obtained results indicated that IL-8 was a reliable predictor of lethal outcome and MODS (p<0.01), IL-12 a reliable predictor of survival (p<0.05), and TNF-alpha a reliable predictor of survival (p<0.05) and MODS (p<0.01).
Maja
M
Surbatović
Krsta
K
Jovanović
Danilo
D
Vojvodić
Nikola
N
Filipović
Dragan
D
Babić
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D009102:Multiple Organ Failure / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D009104:Multiple Trauma / Q000097:blood* / Q000150:complications; D018805:Sepsis / Q000097:blood* / Q000150:complications; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications / Q000175:diagnosis / Q000401:mortality
D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators