Abstract
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.
Alberto Dougnac, Ricardo Castro, Arnoldo Riquelme, Mario Calvo, Eliseo Eugenin, Marco Arellano, Alejandro Pattillo, Tomas Regueira, Marcelo Mercado, Max Andresen
