Importance of Assessment of Cytokine Concentration and PRISM Score in Children with Sepsis

Overview

Sepsis, a subset of SIRS, is the culmination of a series of events initiated by microorganisms and mediated by the host’s immune system. Cytokines seem to have the major role in initiating and maintaining the inflammatory state. After release into the bloodstream they are measurable. TNF-alpha, IL-1 and IL-6 were found to be significantly higher in septic patients and in non-survivors of sepsis. The PRISM score is an objective score of physiologic derangement in critically ill children. The aim of this work was to evaluate the severity of illness by the PRISM score and to find some correlation between this score and levels of TNF-alpha and IL-6 and other inflammatory mediators. In a prospective study 33 children with the diagnosis sepsis/septic shock were involved. In the groups of survivors and non-survivors the authors found statistically significant differences in the PRISM score (P = 0.003) and IL-6 (0.003). TNF-alpha levels did not differ significantly between survivors and non-survivors (P = 0.179). The PRISM score did not correlate significantly with TNF-alpha, IL-6, C-reactive protein, elastase. Medium close correlation was found for IL-6 (0.3875) and elastase (0.3283). A significant correlation was found between TNF-alpha and IL-6 (0.001).

Key words:
sepsis, septic shock, PRISM score, TNF-alpha, IL-6, elastase