ABSTRACT
Introduction:
Detection of sepsis and septic shock is essential, since any delay in initiating a proper treatment is associated with a worse prognosis.
Objective:
To evaluate levels of interleukin-6 (IL-6) early in the onset of the evolution of sepsis associated-organ dysfunction and its relation to the need for more advanced supportive therapies.
Methods:
This is a prospective study at a 43-bed mixed Medical-surgical Intensive Care Unit (ICU) in a university hospital. Patients admitted to the ICU, over 18 years of age, with severe sepsis or septic shock and who presented the first organ dysfunction in less than 48 hours of admission to the ICU were included. We monitored in a daily basis the advanced supportive therapies, need for vasopressors, mechanical ventilation, or renal replacement therapy (RRT), until hospital discharge or death. Blood samples to measure the serum IL-6 levels were collected at the time of inclusion in the study, at 12 and 24 hours later. Patients were divided into two groups according to serum IL-6 levels at admission (Low IL-6: < 1,000 pg/ml or High IL-6: > 1,000 pg/ml).
Results:
The need for norepinephrine was significantly higher in the group with High IL-6 (100%) than in the group with Low IL-6 (62.5%) (p = 0.009). RRT was also more frequent in patients with High IL-6 than in those with Low High IL-6 (87.5% vs. 55.5%, respectively, p = 0.056).
Conclusion:
These findings suggest that the evaluation of serum IL-6 level is useful in the early phase of the severe sepsis and septic shock in order to identify higher-risk patients.
Key words:
sepsis; septic shock; biological markers; multiple organ failure; interleukin-6; hospital mortality