Find in Library
Search millions of books, articles, and more
Indexed Open Access Databases
Cytokine levels in critically ill children with Severe Sepsis and their correlation with the severity of illness and mortality
oleh: Suresh Kumar Angurana, Arun Bansal, Jayashree Muralidharan, Ritu Aggarwal, Sunit Singhi
Format: | Article |
---|---|
Diterbitkan: | Wolters Kluwer Medknow Publications 2018-01-01 |
Deskripsi
Objective: To study the baseline cytokine levels and their correlation with severity of illness and mortality in critically ill children with severe sepsis. Design: Subgroup analysis of a randomized, doubleblind, placebo-controlled trial. Setting: Pediatric intensive care unit of a tertiary care teaching hospital in North India. Patients: Fifty children, 3 months-12 years, with severe sepsis. Material and Methods: Blood was collected at admission for estimation of pro-inflammatory (IL-6, IL-12p70, IL-17, and TNF-α) and anti-inflammatory (IL-10 and TGF-β1) cytokines. Primary outcome: To find out correlation between cytokine levels with severity of illness (PRISM III score). Secondary outcomes: To compare cytokine levels among survivors and non-survivors. Results: Baseline pro-inflammatory cytokine levels [median (IQR)] were IL-6: 189 (35-285) pg/ml, IL-12p: 48 (28-98) pg/ml, IL-17: 240 (133-345) pg/ml, and TNF-α: 296 (198-430) pg/ml; anti-inflammatory cytokine levels were IL-10: 185 (62-395) pg/ml, and TGF-β1: 204 (92-290) ng/ml. The median (IQR) PRISM III score was 15 (12-20). Pro-inflammatory cytokines showed positive correlation with PRISM III score: IL-6 (Spearman's correlation coefficient, ρ=0.273, p=0.06), IL-12 (ρ=0.367, p=0.01), IL-17 (ρ=0.197, p=0.17), and TNF-α (ρ=0.284, p=0.05); and anti-inflammatory cytokines showed negative correlation: IL-10 (ρ= -0.257, p=0.09), and TGF-β (ρ= -0.238, p=0.11). The mortality was 10% (n=5). Among non-survivors, the levels of pro-inflammatory cytokines were significantly higher as compared to survivors [IL-6: 359 (251-499) vs. 157 (97-223) pg/ml, p=0.000; IL-12p70: 167 (133-196) vs. 66 (30-100), p=0.000; IL-17: 400 (333-563) vs. 237 (122-318), p=0.009; and TNF-α: 409 (355-503) vs. 330 (198-415), p=0.002, respectively]. Conclusion: In critically ill children with severe sepsis, pro-inflammatory cytokines showed a positive correlation with severity of illness and were significantly higher among non-survivors.