PMID- 8796390
OWN - NLM
STAT- MEDLINE
DCOM- 19961119
LR  - 20190826
IS  - 0342-4642 (Print)
IS  - 0342-4642 (Linking)
VI  - 22
IP  - 5
DP  - 1996 May
TI  - Blood lactate levels are better prognostic indicators than TNF and IL-6 levels in 
      patients with septic shock.
PG  - 404-8
AB  - OBJECTIVE: Both serum levels of tumor necrosis factor-alpha (TNF alpha) and 
      interleukin-6 (IL-6) and blood lactate levels in patients with septic shock have 
      been shown to correlate with prognosis. The aim of the study was to define the 
      relative predictive value of these measures. PATIENTS: 38 hospitalized patients 
      with septic shock, including 18 survivors and 20 non-survivors. INTERVENTION: 
      Blood TNF alpha (immunoradiometric assay), IL-6 (bioassay) and lactate (enzymatic 
      method) levels were serially measured at the onset of septic shock and after 24 
      and 48 h. RESULTS: TNF alpha levels tended to be higher in the non-survivors than 
      in the survivors at the onset of shock (204 +/- 392 vs 129 +/- 195 pg/ml, p = NS) 
      but decreased similarly in both groups with time (p = 0.03). IL-6 levels at 
      admission were highly variable (9656 +/- 19851 U/ml in the non-survivors and 
      69,222 +/- 248,804 U/ml in the survivors). Log IL-6 decreased similarly in both 
      groups with time (p = 0.004). Admission blood lactate levels were higher in the 
      non-survivors than in the survivors (6.11 +/- 4.78 mEq/l vs 3.49 +/- 2.00 mEq/l, 
      p < 0.05) and decreased significantly with time in all patients (p = 0.024). 
      However, this decrease was greater in the survivors than in the non-survivors (p 
      = 0.003). CONCLUSION: These data indicate that the large variability in TNF alpha 
      and IL-6 levels limit their prognostic significance in patients with septic 
      shock. The predictive value of the trend in cytokine levels over time is not 
      superior to that of trends in blood lactate levels.
FAU - Marecaux, G
AU  - Marecaux G
AD  - Department of Intensive Care, Erasme Hospital, Free University of Brussels, 
      Belgium.
FAU - Pinsky, M R
AU  - Pinsky MR
FAU - Dupont, E
AU  - Dupont E
FAU - Kahn, R J
AU  - Kahn RJ
FAU - Vincent, J L
AU  - Vincent JL
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Intensive Care Med
JT  - Intensive care medicine
JID - 7704851
RN  - 0 (Interleukin-6)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 33X04XA5AT (Lactic Acid)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Interleukin-6/*blood
MH  - Lactic Acid/*blood
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prospective Studies
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Shock, Septic/*blood/immunology/mortality
MH  - Survival Analysis
MH  - Time Factors
MH  - Tumor Necrosis Factor-alpha/*metabolism
EDAT- 1996/05/01 00:00
MHDA- 1996/05/01 00:01
CRDT- 1996/05/01 00:00
PHST- 1996/05/01 00:00 [pubmed]
PHST- 1996/05/01 00:01 [medline]
PHST- 1996/05/01 00:00 [entrez]
AID - 10.1007/BF01712155 [doi]
PST - ppublish
SO  - Intensive Care Med. 1996 May;22(5):404-8. doi: 10.1007/BF01712155.