Intensive Care Medicine

, Volume 20, Issue 5, pp 371–374

Relation between cytokines and routine laboratory data in children with septic shock and purpura

  • J. A. Hazelzet
  • E. van der Voort
  • J. Lindemans
  • P. G. J. ter Heerdt
  • H. J. Neijens
Neonatal and Pediatric Intensive Care

DOI: 10.1007/BF01720912

Cite this article as:
Hazelzet, J.A., van der Voort, E., Lindemans, J. et al. Intensive Care Med (1994) 20: 371. doi:10.1007/BF01720912

Abstract

Objective

To establish the relation between routine laboratory data (lactate, fibrinogen, CRP) and cytokines (TNF,IL-1 and-6) and to estimate their prognostic value in pediatric patients with severe infectious purpura on admission.

Design

Prospective study.

Setting

Pediatric intensive care unit (PICU).

Patients

17 children aged 5–172 months (median 46) were hospitalized in our PICU in 1989–90 with severe infectious purpura.Neisseria meningitidis was isolated in 15 children andHaemophilus influenzae in two. The patients were divided into 3 groups: non-shock, shock and severe shock leading to death. Shock was defined by standard criteria.

Measurements

Arterial blood was sampled for lactate, CRP, fibrinogen, TNF, and IL-1 and-6 on admission. The PRISM (pediatric risk of morality)-score was recorded.

Methods

Statistical analysis was performed with the Student'st-test using the logarithmic values of the cytokine concentration, and Spearman correlation analysis.

Results

According to the shock criteria, 9 patients were in shock of whom 4 did not survive. Significant differences existed between the 3 groups concerning lactate, TNF, and IL-6. Fibrinogen, CRP, IL-1, and PRISM-score discriminated only between survivors and non-survivors. A highly significant correlation existed between cytokines, the PRISM-score and lactate (TNF:r=0.69, IL-1:r=0.56, IL-6:r=0.65, PRISM:r=0.65). A significant inverse correlation existed between cytokines and CRP (TNF:r=−0.55, IL-1:r=−0.64, and IL-6:r=−0.56), and IL-6 and fibrinogen (r=−0.65).

Conclusion

These results show a significant correlation between cytokines and lactate, and lactate, TNF and IL-6 are closely associated with the severity of septic shock with purpura in children.

Key words

Purpura Septic shock Meningococcal infections Cytokines Lactate Prognostic factors 

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • J. A. Hazelzet
    • 1
  • E. van der Voort
    • 1
  • J. Lindemans
    • 2
  • P. G. J. ter Heerdt
    • 2
  • H. J. Neijens
    • 3
  1. 1.Department of Pediatrics, Division of Pediatric Intensive Care, Sophia Children's HospitalErasmus UniversityRotterdamThe Netherlands
  2. 2.Department of Clinical Chemistry, Sophia Children's HospitalErasmus UniversityRotterdamThe Netherlands
  3. 3.Department of Pediatrics, Division of Pediatric Infectious Diseases, Sophia Children's HospitalErasmus UniversityRotterdamThe Netherlands

Personalised recommendations