Serum cytokine levels and cardiovascular variables in septic shock

ABSTRACT

The concentrations of serum interleukin-IB [IL-I beta], interleukin-6 [IL- 6] tumor necrosis factor alpha [TNF alpha]and interferon gamma [IFG] in serum of 20 healthy individuals and 21 patients with septic shocks were measured within four hours after the initial recognition of shock [zero time] and samples were followed up after four and twelve hours. The survivors were six and non survivors fifteen, seven of them with multiple system organ failure [MSOF]. Bacteremia was found in fourteen patients, while urine culture was positive in twelve. On admission, there was no significant difference in all hemodynamic/cardiovascular parameters monitored between survivors and non survivors groups except a significant increased heart rate in non survivors than survivors. Within 24 hours, heart rate of survivors fell to normal. The serum cytokine levels mean + SE of IL-I beta, IL-6, TNF alpha and IFG at all times were significantly higher in patients than controls and no peak values of these cytokines were recorded. A significant correlation was found between serum levels of IL-6 and IFG at four hours and twelve hours. As regard serum cytokine levels and outcome, there was significant increase in serum levels at four hours of IL-6, TNF-alpha and also in total serum levels of TNI alpha and IFG in non survivors compared with survivors group. However, in relation of these cytokines to organ failure both serum levels of IL-6 and IFG were significantly increased in patients with hepatic failure, whereas those with hepatic cirrhosis and heart failure had significant increased levels of IFG only. There was also significant increase in serum levels of IL-6 at four hours, total IL-6 and IFG at twelve hours in patients with MSOF compared with patients without MSOF