Related Experiment Videos
Perioperative TNF alpha and IL-6 concentrations correlate with septic state, organ function, and APACHE II scores in
R Függer1, E Zadrobilek, P Götzinger
1First Surgical Department and Intensive Care, University of Vienna, School of Medicine, Austria.
Objective:
To find out if concentrations of tumour necrosis factor a (TNF alpha) and interleukin-6 (IL-6) play a part in the pathophysiology of intra-abdominal infection, and try to identify patients who would benefit from immunotherapy against TNF alpha.
Design:
Prospective open study.
Setting:
University hospital.
Subjects:
19 consecutive patients (septic shock, n = 4; sepsis syndrome, n = 6; and no sepsis syndrome, n = 9, classified by the APACHE II score and the criteria of the Methyl-prednisolone Severe Sepsis Study Group) who were to undergo their first operation for intra-abdominal infection.
Main Outcome Measures:
Correlation between median (interquartile) concentrations of TNF alpha and IL-6 (pg/ml), and APACHE II score, plasma lactate concentration, and organ function.
Results:
Perioperative concentrations of both TNF alpha (p = 0.001) and IL-6 (p = 0.006) were significantly higher in patients with septic shock. Preoperative cardiovascular and respiratory failure were associated with significantly raised TNF alpha (p < 0.001 in both cases) and IL-6 concentrations (p = 0.02 and p < 0.001, respectively). The preoperative APACHE II score correlated with the increased TNF alpha concentration (r = 0.5, p < 0.001) and plasma lactate concentration with that of IL-6 (r = 0.7, p = 0.003).
Conclusion:
Perioperative TNF alpha and IL-6 concentrations correlated with the severity of intra-abdominal infection, so it is possible that patients who present with either septic shock or the sepsis syndrome may benefit from immunotherapy against TNF alpha.