Pro- and anti-inflammatory balance of septic patients is associated with severity and outcome

Dougnac, A; Castro R.; Regueira T.; Mercado M.; Andresen M.; Riquelme A.; Calvo M.; Eugenin, E; Arellano M.; Pattillo, A

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.

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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
Volumen: 10
Número: 3
Editorial: Indonesian Society of Critical Care Medicine
Fecha de publicación: 2007
Página de inicio: 99
Página final: 107
Idioma: eng