Correlation between interleukin-6 and septic shock in children

  • Stephanie Yulianto Department of Child Health, Sam Ratulangi University Medical School/Pro. Dr. R. D. Kandou Hospital, Manado
  • Ari Runtunuwu Department of Child Health, Sam Ratulangi University Medical School/Pro. Dr. R. D. Kandou Hospital, Manado
  • Vivekenanda Pateda Department of Child Health, Sam Ratulangi University Medical School/Pro. Dr. R. D. Kandou Hospital, Manado
  • Jose Mandei Department of Child Health, Sam Ratulangi University Medical School/Pro. Dr. R. D. Kandou Hospital, Manado
  • Julius Lolombulan Department of Child Health, Sam Ratulangi University Medical School/Pro. Dr. R. D. Kandou Hospital, Manado
Keywords: sepsis, interleukin-6

Abstract

Background Sepsis is a lifeô€†threatening condition and the most
common cause of death in intensive care units in developing
countries, such as Indonesia. The first clinical signs of sepsis are
usually nonô€†spedfic. More specific signs and laboratory parameters
often occur late and are associated 'With organ dysfunction and
high mortality rates. Interleukinô€†6 (IL--6) is a biomarker reported to
be superior to clinical signs and conventional tests for sepsis. IL--6
levels may indicate microorganism invasion, as well as progression
of infection into sepsis, severe sepsis, and septic shock.
Objective To evaluate a correlation between interleukin (IL)ô€†6
and septic shock in children
Methods This crossô€†sectional study was conducted in the pediatric
intensive care unit of Prof. Dr. R.D. Kandou Hospital, Manado,
between June to September 2011. Subjects were children with
sepsis or septic shock aged 1 month to 13 years, v.ith diagnoses
based on the International Pediatric Sepsis Consensus Conference
Criteria 2005. A oneô€†time measurement of IL--6 plasma levels
was done at the time of diagnosis. Data was analyzed by logistic
regression test using SPSS version 17 software. A P value of <0.05
indicated statistical significance.
Results The mean IL--6 plasma level in the septic group was 1.68
(95%CI 1.45 to 1.91) pg/mL and that of the septic shock group
was 2.33 (95%CI 1.79 to 2.86) pg/mL. Our results showed a
strong positive correlation between ILô€†6 plasma levels v.ith the
probability of septic shock in children v.ith sepsis (regression
coefficientô€‡1.3lO, Pô€‡O.024).
Conclusion Higher plasma IL--6 levels were associated v.ith a
higher risk of septic shock in children with sepsis. [Paediatr
rndones.2012;52:352-5].

References

1. Enrione MA, Powell KR. Sepsis, septic shock, and systemic
inflammation. In: Kliegman RM, Nelson EB, Jenson HB,
Stanton BF, editors. Nelson texbook of pediatrics. 18th ed.
Philadelphia: Elsevier Saunders; 2007. p. 1094-9.
2. Glliers H, Whitehouse T, Tunnicliffe B.S erious complications
of sepsis.I n: Daniels R, Nu fbeam T, editors.A BC of sepsis. l,1t
ed. United Kingdom: Wiley, Blackwell; 2010. p. 15-9.
3. Rudis MI, Rowland KL. Current concepts in severe sepsis
and septic shock. 1 Phann Pract. 2005;18:351-62.
4. Rachmawati RI, Pudjiaji AH, Tridjaja B. Insufisiensi adrenal
pada anak dengan sepsis berat dan syok sepsis.I n: Lubis B, Ali
M, Yanni GN, Trisnawati Y, Ramayani OR, editors.K umpulan
Naskah Lengkap PIT IV IKA. Medan: USU press; 2010. p.
223-36.
5. Bone RC, Grodzin CJ, Balk RA. Sepsis: a new hypothesis for
pathogenesis of disease process. Chest. 1997;112:235A3.
6. Levi MM, F ink MP, Marshal lC, Abraham E, Angus D,
Cook D, et a l . 2001 SCCM/ESICM/ACCP/AT S/SIS
international sepsis definitions conference. Intensive Care
Med.2003;29:530-8.
7. Goldstein B, Giroir B, Randolph A. International pediatric
sepsis consensus conference: definitions for sepsis and
organ dysfunction in pediatrics. Pediatr Crit Care Med.
2005:6:2-8.
8. Toni D. T he systemic inflammatory response syndrome, sepsis,
and septic shock. In: Long SS, Pickering LK, Prober CG,
editors.P rinciples and practice of pediatric infectious diseases.
2nd ed. New York: Churcill Livingstone; 2003. p. 93-6.
9. Ventetuolo CE, Levy MM. Sepsis: a clinical update. Clin J
Am Soc Nephro!. 2008;3,571-7.
10. Hermawan GA. Imunopatobiologik sepsis dan penata􀁐
laksanaannya. In: Proceedings book perhimpunan peneliti
penyakit tropik dan infeksi (PETRI): simposium nasional
sepsis dan antimikrobial terkini. Surakarta: PETRI; 2007.
p.31-43.
11. Opal SM, Scannon PJ, Vincent JL. Relationship between
plasma levels of lipopolysaccharide (LPS) and LPS􀁐binding
protein in patients v,ith severe sepsis and septic shock. J
Infect Dis. 1999;180,1584-9.
12. Balk RA, Wesley E, Goyette RE. T he pathophysiology
of sepsis and associated acute organ dysfunction. In:
Sepsis handbook, national initiative in sepsis education.
Philadelphia, Saunders; 2001. p. 26-44.
13. Strait RT, Kelly KJ, Kurup VP. Tumor necrosis factor􀁐a,
interleukin􀁐 1 /3, and interleukin􀁐6 levels in febrile young
children with and v,ithout occult bacteremia. Pediatrics.
1999; 104, 1321-6.
14. Jones SA, Horiuchi S, Topley n, Yamamoto N, Fuller GM.
T he soluble interleukin 6 receptor: mechanism of production
and implications in disease. FASEB J. 2001; 15 :43􀁐58.
15. Pavare J, Grope I, Kalnins I, Gardovska D. High􀁐mobility
group box􀁐l protein, lipopolysacharide􀁐binding protein,
interleukin􀁐6 and C􀁐reactive protein in children with
community acquired infections and bacteraemia: a
prospective study. BMC Infect Dis. 2010;10:28.
16. Tapisiz AA, Ergenekon E, Erbas D, Oktem M, Demirel N,
Gucuyener K, et al. Interleukin􀁐6 and nitric oxide levels in
neonatal sepsis. Turk J Med Sci. 2007;37:261-6.
17. Carcillo JA, Planquois JMS, Goldstein B. Early markers of
infection and sepsis in newborns and children. Adv Sepsis.
2006;5,118-25.
18. Ng P C , Li K, Wong RP. Proinflammatory and anti􀁐
inflammatory cytokine responses in preterm infants
with systemic infection. Arch Dis Child Fetal Neonat.
2003 ;88,F209-13.
19. Dahmet MK, Rudolph A, Viatli S, Quansey MQ. Genetic
polymorphism in sepsis. Pediatr Crit Care Med. 2005;6:61􀁐
73.
20. Ng PC, Lam HS. Diagnostic markers for neonatal sepsis.
CUff Opin Pediatr. 2006;18,125-31.
21. Fioretto JR, MartinJG, Kurokawa CS, Carpi MF, Bonatto
RC, Padovani CR. Interleukin􀁐6 and procalcitonin
in children with sepsis and septic shock. Cytokine.
2008;43,160-4.
22. Briassoulis G, Venkataraman S, T hompson A. Cytokines and
metabolic pattern in pediatric patients v,ith critical illness.
Clin Dev Immuno!. 2010;10,1-11.
23. Hendra, Runtunuwu AL, Manoppo JIC. Pediatric logistic
organ dysfunction (PELOD) score as prognosis multiple
organ failure in sepsis. Pediatr Indones. 20 1O;50:226􀁐31.
24. Runtunuwu AL, Manoppo JIC, Rampengan TH, Rampengan
NH, Kosim S. Efektivitas pemeriksaan prokalsitonin sebagai
petanda dini sepsis pada bayi dan anak. Sari Pediatri.
2008;9,319-22.
25. Watson RS, Carcillo JA, Linde􀁐Zv,irble WT, Clermont G,
Lidicker J, Cerra FB, et al. T he epidemiology of severe sepsis
in children in United States. Am J Respir Crit Care Med.
2003 ;167 ,695-701.
Published
2012-12-31
How to Cite
1.
Yulianto S, Runtunuwu A, Pateda V, Mandei J, Lolombulan J. Correlation between interleukin-6 and septic shock in children. PI [Internet]. 31Dec.2012 [cited 23Dec.2024];52(6):352-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/500
Received 2016-09-08
Accepted 2016-09-08
Published 2012-12-31