Relation between cytokines and routine laboratory data in children with septic shock and purpura

J. A. Hazelzet*, E. van der Voort, J. Lindemans, P. G.J. ter Heerdt, H. J. Neijens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

49 Citations (Scopus)

Abstract

Objective: To establish the relation between routine laboratory data (lactate, fibrinogen, CRP) and cytokines (TNF,IL-1 and-6) and to estimate their prognostic value in pediatric patients with severe infectious purpura on admission. Design: Prospective study. Setting: Pediatric intensive care unit (PICU). Patients: 17 children aged 5-172 months (median 46) were hospitalized in our PICU in 1989-90 with severe infectious purpura. Neisseria meningitidis was isolated in 15 children and Haemophilus influenzae in two. The patients were divided into 3 groups: non-shock, shock and severe shock leading to death. Shock was defined by standard criteria. Measurements: Arterial blood was sampled for lactate, CRP, fibrinogen, TNF, and IL-1 and-6 on admission. The PRISM (pediatric risk of morality)-score was recorded. Methods: Statistical analysis was performed with the Student's t-test using the logarithmic values of the cytokine concentration, and Spearman correlation analysis. Results: According to the shock criteria, 9 patients were in shock of whom 4 did not survive. Significant differences existed between the 3 groups concerning lactate, TNF, and IL-6. Fibrinogen, CRP, IL-1, and PRISM-score discriminated only between survivors and non-survivors. A highly significant correlation existed between cytokines, the PRISM-score and lactate (TNF:r=0.69, IL-1:r=0.56, IL-6:r=0.65, PRISM:r=0.65). A significant inverse correlation existed between cytokines and CRP (TNF:r=-0.55, IL-1:r=-0.64, and IL-6:r=-0.56), and IL-6 and fibrinogen (r=-0.65). Conclusion: These results show a significant correlation between cytokines and lactate, and lactate, TNF and IL-6 are closely associated with the severity of septic shock with purpura in children.

Original languageEnglish
Pages (from-to)371-374
Number of pages4
JournalIntensive Care Medicine
Volume20
Issue number5
DOIs
Publication statusPublished - May 1994

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