Abstract

Background: Fluid resuscitation is a key management strategy for septic shock patients who experience increased capillary permeability. Using capillary leakage index (CLI) and C-X-C motif chemokine ligand 10 (CXCL10) biomarkers, capillary leakage can be assessed not only through hemodynamic changes but also as a distinct phenomenon. This study aimed to evaluate the relationship between resuscitation and capillary leakage in septic shock patients.

Methods: This study employed an observational cross-sectional design, including 35 septic patients admitted to the Intensive Care Unit (ICU) of Dr. Wahidin Sudirohusodo Hospital. Standard sepsis management was performed, and CLI and CXCL10 levels were measured on the first and third days after sepsis diagnosis, along with cumulative fluid balance delta assessment. The study was conducted from July to November 2024.

Results: The mean CLI value on the first day was 68.42±57.28, decreasing to 44.14±46.43 on the third day. The mean CXCL10 value on the first day was 47.70±45.47, decreasing to 29.34±28.12 on the third day. The mean cumulative fluid balance delta was 727.88±1538.62. CLI and CXCL10 levels on the third day showed a significant correlation with Sequential Organ Failure Assessment (SOFA) scores, whereas no correlation was found on the first day. CLI was significantly correlated with Acute Physiology And Chronic Health Evaluation (APACHE) II scores, whereas CXCL10 did not show a significant correlation with APACHE II. A significant correlation was observed between CLI, CXCL10, and cumulative fluid balance delta on the third day of treatment.

Conclusion: CLI and CXCL10 can be used as biomarkers for capillary leakage to assess clinical conditions and prognosis within <72 hours. Although CXCL10 is not as strong as CLI, it can still serve as an indicator of capillary leakage in septic shock patients. Evaluating CLI and CXCL10 biomarkers on the third day is recommended for an accurate assessment of the patient’s clinical condition.

Indra Sukmana Putra, Ari Santri Palinrungi, Haizah Nurdin, Hisbullah, Faisal Muchtar, Syamsul Hilal Salam