To obtain predictors of organ failure (OF), we studied markers of systemic inflammation [circulating levels of interleukin-6 (IL-6), IL-8, soluble IL-2 receptor (sIL-2R), soluble E-selectin and C-reactive protein, and neutrophil and monocyte CD11b expression] and routine blood cell counts in 20 patients with systemic inflammatory response syndrome and positive blood culture. Eight patients with shock due to community-acquired infection developed OF, whereas 11 normotensive patients and one patient with shock did not (NOF group). The first blood sample was collected within 48 h after taking the blood culture (T1). OF patients, as compared with NOF patients, had at T1 a lower monocyte count, a lower platelet count, higher levels of CD11b expression on both neutrophils and monocytes, and higher concentrations of IL-6, IL-8 and sIL-2R. C-reactive protein and soluble E-selectin concentrations did not differ between groups. No parameter alone identified all patients that subsequently developed OF. However, a sepsis-related inflammation severity score (SISS), developed on the basis of the presence or absence of shock and on the levels of markers at T1, identified each patient that developed OF. The maximum SISS value was 7. The range of SISS values in OF patients was 2–5, and that in NOF patients was 0–1. In conclusion, high levels of CD11b expression, depressed platelet and monocyte counts, and high concentrations of IL-6, IL-8 and sIL-2R predict OF in patients with community-acquired septic shock, and the combination of these markers may provide the means to identify sepsis patients who will develop OF.
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Research Article|
September 15 1999
Markers of systemic inflammation predicting organ failure in community-acquired septic shock
Annika TAKALA;
*Department of Anesthesia, Helsinki University Central Hospital, Anestesiaosasto, P.O. Box 260, FIN-00029 HYKS, Finland
Correspondence: Dr Annika Takala (e-mail [email protected]).
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Irma JOUSELA;
Irma JOUSELA
*Department of Anesthesia, Helsinki University Central Hospital, Anestesiaosasto, P.O. Box 260, FIN-00029 HYKS, Finland
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Sten-Erik JANSSON;
Sten-Erik JANSSON
†Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
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Klaus T. OLKKOLA;
Klaus T. OLKKOLA
*Department of Anesthesia, Helsinki University Central Hospital, Anestesiaosasto, P.O. Box 260, FIN-00029 HYKS, Finland
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Olli TAKKUNEN;
Olli TAKKUNEN
*Department of Anesthesia, Helsinki University Central Hospital, Anestesiaosasto, P.O. Box 260, FIN-00029 HYKS, Finland
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Arto ORPANA;
Arto ORPANA
†Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
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Sirkka-Liisa KARONEN;
Sirkka-Liisa KARONEN
†Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
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Heikki REPO
Heikki REPO
‡Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
§Department of Microbiology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland
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Publisher: Portland Press Ltd
Received:
February 18 1999
Revision Received:
May 20 1999
Accepted:
July 12 1999
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 1999
1999
Clin Sci (Lond) (1999) 97 (5): 529–538.
Article history
Received:
February 18 1999
Revision Received:
May 20 1999
Accepted:
July 12 1999
Citation
Annika TAKALA, Irma JOUSELA, Sten-Erik JANSSON, Klaus T. OLKKOLA, Olli TAKKUNEN, Arto ORPANA, Sirkka-Liisa KARONEN, Heikki REPO; Markers of systemic inflammation predicting organ failure in community-acquired septic shock. Clin Sci (Lond) 1 November 1999; 97 (5): 529–538. doi: https://doi.org/10.1042/cs0970529
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