Critical Care and Shock

Interleukin-6 as an early marker mortality prediction in the first day of pediatric septic shock in the Pediatric Intensive Care Unit

Abstract

Introduction: Early identification of infection severity and organ dysfunction is crucial in improving outcomes for patients with sepsis.

Objective: We aimed to develop an early marker that can early predict mortality in pediatric patients with septic shock.

Method: Prospective observational study of 6 months -18 years pediatric patients with septic shock who were admitted to the Pediatric Intensive Care Unit (PICU), Dr. Soetomo General Academic Hospital Surabaya. The measurement of interleukin 6 (IL6) levels was carried out by Human IL6 ELISA test on days 1, 2, and 3 after entering the PICU. The lactate levels and Pediatric Logistic Organ Dysfunction (PELOD) 2 score were also used as predictors of mortality.

Results: A total of 19 pediatric patients with septic shock were included in the inclusion criteria of this study. Subjects were divided into the survivor (n=9) and the non-survivor group (n=10). There was a significant difference in IL6 levels between the survivor and non-survivor groups on day 1 (p<0.05). However, the levels of IL6 on day 2 and day 3 did not show a significant difference as a predictor of mortality at the cut-off value of 593.34 pg/ml with a sensitivity of 60% and specificity of 100%. This study showed that IL6 levels on day 1 had a positive correlation with mortality outcomes (p<0.05). The PELOD 2 score showed a significant difference, but the lactate levels did not show a significant difference between the survivor and nonsurvivor groups.

Conclusions: IL6 levels measured at admission can be used as an early marker for predicting firstday mortality in pediatric septic shock in the PICU.