The aim was to determine whether serum
cytokine profiling early after
burn can be used to identify patients at high risk of developing and subsequently dying of
sepsis. A case series study was designed to determine whether serum
cytokine profiling allows identification of patients at highest risk of developing and dying of
sepsis at the time of hospital admission. All patients were treated according to the standard of
burn care at our facility. Forty-four children (1-19 years old) with more than 40% of total body surface area and admitted within 7 days postburn were studied. None had
infections or
sepsis at the time of admission. Serum was collected before the first operation, and concentrations of 17
cytokines were measured. Diagnosis of
sepsis was made at autopsy with identification of the pathogen. Fifteen patients developed
sepsis and died, whereas 29 patients did not develop
sepsis and survived. Significant elevations in serum
interleukin (IL) 6,
IL-8,
IL-10, granulocyte-monocyte
colony-stimulating factor,
interferon gamma (IFN-gamma),
tumor necrosis factor (TNF), and
IL-12 p70 were found at the time of admission of patients who subsequently developed and died of
sepsis when compared with burned patients who did not develop
sepsis (P < 0.05). Multiple logistic regression analysis revealed that patients with a combination of elevated
IL-6 and
IL-12 p70 and lower TNF had an elevated risk of dying of
sepsis. Serum
IL-6,
IL-8,
IL-10, granulocyte-monocyte
colony-stimulating factor, IFN-gamma, TNF, and
IL-12 p70 are expressed differently in patients who die of
sepsis versus those who never become septic. In addition, serum
IL-6,
IL-12 p70, and TNF can be used to identify burned patients who are at high risk of death from
sepsis.