Persistent elevation of serum interleukin-6 in intraabdominal sepsis identifies those with prolonged length of stay.
OBJECTIVE
Elevated serum interleukin-6 (IL-6) levels in patients with intraabdominal sepsis have been associated with increased morbidity and mortality. The authors hypothesized that after surgical intervention a persistent elevation of IL-6 would more accurately reflect the inflammatory state and thus predict the subsequent time to recovery better than the preoperative value alone.


METHODS
Nineteen consecutive children with peritonitis and manifestations of the systemic inflammatory response syndrome were enrolled prospectively. IL-6 levels were determined from pre- and postoperative serum samples (within 12 to 24 hours) by enzyme-linked immunosorbant assay (ELISA). Patient postoperative length of stay (LOS) was recorded.


RESULTS
Before surgery, patient serum IL-6 levels ranged from 48 to 132,546 pg/mL. LOS ranged from 4 to 60 days, with subjects falling into 2 groups of < or =11 (n = 14) and > or =25 (n = 5) days. Using an IL-6 level greater than 500 pg/mL to predict a prolonged LOS (>11 days), a persistent elevation of IL-6 postoperatively appears to increase the likelihood of a prolonged LOS.


CONCLUSIONS
Persistent IL-6 levels greater than 500 pg/mL may be useful in identifying pediatric intraabdominal sepsis patients with prolonged LOS and presumably greater morbidity. Rapid identification of these patients may allow for novel therapeutic interventions.
Division of Pediatric Pharmacology and Critical Care Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH 44106, USA.
Samir Q
SQ
Latifi
Mary Ann
MA
O'Riordan
Alan D
AD
Levine
Anthony
A
Stallion
D018784:Abdominal Abscess / Q000097:blood / Q000209:etiology; D000293:Adolescent; D001064:Appendicitis / Q000097:blood / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000097:blood* / Q000209:etiology; D006207:Half-Life; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood*; D007813:Laparotomy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D010538:Peritonitis / Q000097:blood* / Q000209:etiology; D011182:Postoperative Care; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012086:Reoperation; D018805:Sepsis / Q000097:blood*; D013530:Surgical Wound Infection / Q000097:blood* / Q000209:etiology
D015415:Biomarkers; D015850:Interleukin-6