In:
Military Medical and Pharmaceutical Journal of Serbia, National Library of Serbia, , No. 00 ( 2023), p. 54-54
Abstract:
Background/Aim. The role of the complex sepsis-related immune response has
not been fully clarified, and still remains a subject matter of
investigations. Nowadays, sepsis is considered a dynamic syndrome
characterised by many, often antagonistic, phenomena from hyperinflammation
to anergy, or immunoparalysis. On the basis of pro- and anti-inflammatory
mediators in the critically ill with sepsis, the aim of the study was to
determine whether the cytokine profile differs according to the type of
bacterial causative agent, as well as to assess the prognostic value
regarding the outcome. The outcome measure has been hospital mortality.
Methods. Blood serum samples have been taken from 125 critically ill
patients with severe secondary sepsis as a consequence of peritonitis,
pancreatitis, or trauma, who had been admitted to the surgical intensive
care unit (SICU). The average age of the patients was 57.7?17.3. Of the
total number of patients, 84 (67,2%) were males, and 41 (32,8%) were
females. The levels of pro-inflammatory ? interleukin 1-alpha (IL-1?),
IL-1?, IL-6, IL-8, IL-12?70, IL-17?, tumor necrosis factor alpha (TNF?),
interferon-gamma (IFN-?), interferon-gamma-inducible protein-10 (IP 10),
monocyte chemoattractant protein-1(MCP-1), macrophage inflammatory protein
alpha and beta (MIP-1? and MIP-1?), as well as anti-inflammatory mediators
IL-4, IL-10, IL-13, IL-27, IL-31 and IL-33 were determined at three time
intervals - on the day of admission (the first day), and then on the third
and fifth day. Through standard microbiological analyses, the type of the
bacterial causative agent has been determined. Results. On the third day of
measurement, significant differences in the cytokine levels with regard to
the nature of bacteremia were determined in all pro- and anti-inflammatory
cytokines, except for IL-8. Generally, the lowest levels were observed in
patients with polymicrobial blood culture. On the first and fifth days of
measurement, no significant differences in the cytokine levels with regard
to the nature of bacteriemia was found. The only significant predictor of
the lethal outcome on the first measurement day was IL-17?, AUR ROC of 0,665
(95% confidence interval of 0,519-0,791, ?=0.034) with secondary sepsis as a
complication of peritonitis. Conclusion. According to the type of the
bacterial causative agent, the lowest levels of cytokines have been observed
in patients with the polymicrobial blood culture. IL- 17? is a good
predictor of the outcome in patients with peritonitis as an underlying
condition of secondary sepsis. The low level of IL-17? in these patients
predicted a lethal outcome on the first day of measurement. On the other
hand, the levels of other cytokines correlated with the outcome only on the
fifth day of measurement, and they were higher in survivors than in
non-survivors.
Type of Medium:
Online Resource
ISSN:
0042-8450
,
2406-0720
DOI:
10.2298/VSP230105054D
Language:
English
Publisher:
National Library of Serbia
Publication Date:
2023
detail.hit.zdb_id:
2169819-3
SSG:
15,3
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