Am. J. Respir. Crit. Care Med., Volume 156, Number 3, September 1997, 825-832

Cytokine Profile and Correlation to the APACHE III and MPM II Scores in Patients with Sepsis

ELISABETH PRESTERL, THOMAS STAUDINGER, MARIA PETTERMANN, ANDREA LASSNIGG, HEINZ BURGMANN, STEFAN WINKLER, MICHAEL FRASS, and WOLFGANG GRANINGER

Department of Medicine I and Department of Anaesthesiology and Intensive Care Medicine, University of Vienna, Allgemeines Krankenhaus, Waehringer Guertel, Vienna, Austria

In 35 patients fulfilling the criteria of systemic inflammatory response syndrome (SIRS) of infectious origin, tumor necrosis factor- (TNF-), interleukin-6 (IL-6), tumor necrosis factor-soluble receptor (TNF-sR), and interleukin-12 (IL-12), C-reactive protein (CRP) levels and the Acute Physiology, And Chronic Health Evaluation III score (APACHE III) were determined on days 1 to 7, 14, 21, and 28. The Mortality Probability Models (MPM) II sepsis score was assessed at the time of admission into the study. The MPM II sepsis score correlated with IL-6 plasma levels on day 1. The APACHE III scores correlated with plasma levels of TNF-sR on days 2-7, with IL-6 levels on days 3-7, and with CRP levels on days 4-7 (p < 0.01). The MPM II sepsis score, the APACHE III score, and the IL-6, TNF-sR, and CRP levels were significantly different between survivors and nonsurvivors and between patients with and without shock (p < 0.05). A significant decrease of the APACHE III scores, IL-6, and CRP levels was observed over the study period in the survivor group only (p < 0.05), while neither the dynamics of TNF- nor IL-12 plasma levels contributed to the risk estimation of mortality.

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