Author/Authors :
Hamishehkar, H tabriz university of medical sciences - Faculty of Pharmacy - Department of Clinical Pharmacy, تبريز, ايران , Hamishehkar, H tehran university of medical sciences tums - Faculty of Pharmacy and Pharmaceutical Sciences Research Center - Department of Clinical Pharmacy, تهران, ايران , Beigmohammadi, MT Imam Khomeini hospital - Department of Anesthesiology and Critical Care Medicine , Abdollahi, M. , Ahmadi, A. Sina hospital - Department of Anesthesiologyand Critical Care Medicine , Mahmoodpour, A Imam Khomeini hospital - Departmentof Anesthesiology and Critical Care Medicine , Mahmoodpour, A Sina hospital - Department of Anesthesiologyand Critical Care Medicine , Mirjalili, M.R Sina hospital - Department of Anesthesiologyand Critical Care Medicine , Abrishami, R. tehran university of medical sciences tums - Faculty of Pharmacy and Pharmaceutical SciencesResearch Center - Department of Clinical Pharmacy, تهران, ايران , Khoshayand, M.R. tehran university of medical sciences tums - Faculty of Pharmacy, and Pharmaceutical Sciences Research Center - Department of Food and Drug Control, تهران, ايران , Eslami, K tehran university of medical sciences tums - Faculty of Pharmacy and Pharmaceutical SciencesResearch Center - Department of Clinical Pharmacy, تهران, ايران , Kanani, M Ministry of Health and Medical Education - Deputy of Food and Drug, ايران , Baeeri, M , Mojtahedzadeh, M tehran university of medical sciences tums - Faculty of Pharmacy and Pharmaceutical SciencesResearch Center - Department of Clinical Pharmacy, تهران, ايران , Mojtahedzadeh, M Sina hospital - Department of Anesthesiologyand Critical Care Medicine
Abstract :
Background and the purpose of the study: sepsis is one of the most widespread and lethal disease in Intensive Care Units (ICU). Based on pathophisyology of sepsis, it seems that routine laboratory tests combined with analysis of pro-inflammatory cytokines plasma levels, help clinicians to have more information about disease progress and its correct management. Methods: This was a prospective observational study to determine the predictive role of Tumor Necrosis Factor alpha (TNF-α), Interleukin (IL)-1βand IL-6 as three main pro-inflammatory cytokines and Acute Physiology and Chronic Health Evaluation (APACHE II) and Sequential Organ Failure Assessment (SOFA) as two scoring systems in mortality of critically ill patients with severe sepsis. Fifty and five patients with criteria of severe sepsis were included in this study. An exclusion criterion was post Cardiopulmonary Resuscitation (CPR) status. Cytokines(TNF-α, IL-1β and IL-6) were assayed in the first, third and seventh days in blood of patients.Results and major conclusion: Among three measured cytokines, sequential levels of TNF-α and IL-6 showed significant differences between survivors and nonsurvivors. IL-6 had a good correlation with outcome and scoring systems during the period of this study. The areas under the receiver operating characteristic (AUROC) curve indicated that APACHE II (0.858, 0.848,0.861) and IL-6 (0.797, 0.799, 0.899) had discriminative power in prediction of mortality during sequental measured days. Multiple logestic regression analysis identified that evaluation of APACHE II and TNF-α in the first day and APACHE II and IL-6 in the third and seventh days of severe septic patients are independent outcome predictors. Results of this study suggest that IL-6 and APACHE II are useful cytokine and scoring systems respectively in prediction of mortality and clinical evaluation of severe septic patients.
Keywords :
TNF , α , IL , 1β , IL , 6 , APACHE , SOFA , Severe sepsis
