Titre
Cytokines, nitrite/nitrate, soluble tumor necrosis factor receptors, and procalcitonin concentrations: comparisons in patients with septic shock, cardiogenic shock, and bacterial pneumonia
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
de Werra, I.
Auteure/Auteur
Jaccard, C.
Auteure/Auteur
Corradin, S. B.
Auteure/Auteur
Chiolero, R.
Auteure/Auteur
Yersin, B.
Auteure/Auteur
Gallati, H.
Auteure/Auteur
Assicot, M.
Auteure/Auteur
Bohuon, C.
Auteure/Auteur
Baumgartner, J. D.
Auteure/Auteur
Glauser, M. P.
Auteure/Auteur
Heumann, D.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0090-3493
Statut éditorial
Publié
Date de publication
1997-04
Volume
25
Numéro
4
Première page
607
Dernière page/numéro d’article
13
Notes
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Apr
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Apr
Résumé
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.
Sujets
PID Serval
serval:BIB_968497C85C12
PMID
Date de création
2008-01-24T15:31:21.460Z
Date de création dans IRIS
2025-05-21T00:35:53Z