| Cytokines, nitrite/nitrate, soluble tumor necrosis factor receptors, and procalcitonin concentrations: comparisons in patients with septic shock, cardiogenic shock, and bacterial pneumonia. | |
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MedLine Citation:
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PMID: 9142024 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To determine and compare the respective concentrations of tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, soluble TNF receptors, nitrite/nitrate (NO2-/NO3-), and procalcitonin in the plasma of patients with septic shock, cardiogenic shock, and bacterial pneumonia without shock; and to assess the predictive value of these mediators in defining patients with septic shock. DESIGN: Cohort study, comparing normal volunteers (controls) and patients with septic shock, cardiogenic shock, and bacterial pneumonia. SETTING: A collaborative study among an intensive care unit, an emergency room, and three research laboratories. PATIENTS: Mediators were measured at various times in 15 patients with septic shock (during the shock phase and during the recovery phase), in seven patients with cardiogenic shock during the shock phase, and in seven patients with severe bacterial pneumonia on day 1 of admission. INTERVENTIONS: Blood samples were collected at various times during the course of the disease. MEASUREMENTS AND MAIN RESULTS: TNF-alpha values were highest in the acute phase of septic shock (53 to 131 pg/mL during septic shock), while patients with bacterial pneumonia had intermediate concentrations (32 pg/mL). TNF-alpha concentrations were normal in patients with cardiogenic shock. IL-6 concentrations were highest in patients with acute septic shock (85 to 385 pg/mL). However, in contrast to TNF-alpha concentrations, IL-6 concentrations were normal in patients with bacterial pneumonia and increased in patients with cardiogenic shock (78 pg/mL). Soluble TNF receptors were increased in all three groups vs. controls, with the highest increase in patients with septic shock. NO2-/NO3- concentrations were highest (72 to 140 mM) in patients with septic shock, and were < 40 mM in the other groups of patients. Procalcitonin concentrations were only markedly increased in patients with septic shock (72 to 135 ng/mL, compared with approximately 1 ng/mL in the three other groups). The best predictive value for septic shock was found to be the measurements of NO2-/NO3- and procalcitonin concentrations. CONCLUSIONS: These observations showed that increase of proinflammatory cytokines was a consequence of inflammation, not of shock. In this study comparing various shock and infectious states, measurements of NO2-/NO3- concentration and procalcitonin concentration represented the most suitable tests for defining patients with septic shock. |
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Authors:
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I de Werra; C Jaccard; S B Corradin; R Chioléro; B Yersin; H Gallati; M Assicot; C Bohuon; J D Baumgartner; M P Glauser; D Heumann |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 25 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 1997 Apr |
Date Detail:
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Created Date: 1997-06-05 Completed Date: 1997-06-05 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 607-13 Citation Subset: AIM; IM |
Affiliation:
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Division of Infectious Diseases, Centre Hospitalier Universitaire Vaudois-Lausanne, Switzerland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Biological Markers Calcitonin / blood* Cohort Studies Cytokines / blood* Diagnosis, Differential Female Humans Interleukin-6 / blood Male Middle Aged Nitrates / blood* Nitrites / blood* Pneumonia, Bacterial / blood Predictive Value of Tests Protein Precursors / blood* Receptors, Tumor Necrosis Factor / blood* Shock, Cardiogenic / blood Shock, Septic / blood*, diagnosis* Tumor Necrosis Factor-alpha / analysis |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Cytokines; 0/Interleukin-6; 0/Nitrates; 0/Nitrites; 0/Protein Precursors; 0/Receptors, Tumor Necrosis Factor; 0/Tumor Necrosis Factor-alpha; 56645-65-9/procalcitonin; 9007-12-9/Calcitonin |
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