Pro- and anti-inflammatory balance of septic patients is associated with severity and outcome
Keywords: sensitivity, survival, tertiary, sepsis, inflammation, blood, care, admission, risk, disease, association, death, severity, fluid, human, failure, time, aged, health, agent, outcome, multiple, adult, shock, article, marker, hypotension, resuscitation, university, unit, immunomodulation, assessment, sampling, antibiotic, organ, controlled, study, hospital, septic, interleukin, Rate, noradrenalin, biological, 6, course, intensive, 10
Purpose: To study inflammatory profile in patients with sepsis, severe sepsis and septic shock with regards to organ dysfunction and outcome, and to identify a pattern associated with more catastrophic course of illness, organ failure and risk of death. Material and methods: Twenty-nine consecutive patients with sepsis admitted to a medical Intensive Care Unit of a tertiary university hospital (November 2002-December 2003). Plasmatic levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) as pro-inflammatory and anti-inflammatory markers were measured at baseline, 12, 24 and 48 hours of evolution. Results: There is a positive association between higher levels of IL-6 and severity of the septic process, organ dysfunctions and risk of death, statistically significant at anytime (at baseline, 12, 24 and 48 hours, p <0.05). Higher IL-6/IL-10 ratios associate significantly with risk of death at 24 hours (RR=1.45 if higher or equal to the median). Conclusions: Plasmatic biomarkers measurement during the initial phase of sepsis may help to individualize therapy. An evaluation at 24 h based on IL-6/IL-10 ratio may anticipate a more aggressive inflammatory profile. These patients would specially benefit from immunomodulating therapies to improve survival.
|Título según SCOPUS:||Pro- and anti-inflammatory balance of septic patients is associated with severity and outcome|
|Título de la Revista:||?Critical Care and Shock|
|Editorial:||Indonesian Society of Critical Care Medicine|
|Fecha de publicación:||2007|
|Página de inicio:||99|