Sepsis: a follow-up of cytokine production in different phases of septic patients.

Sepsis and its sequelae are still a major cause of morbidity and mortality on today's intensive care units. The evidence that primary responses in sepsis are mediated by cytokines has led to various approaches to evaluate the potential of these mediators as markers of disease progression, prognosis or treatment. This study evaluated variations of plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), interleukin-1 (IL-1) and nitric oxide (NO) in different phases of sepsis and compared the relation of these data with disease evaluation and outcome. No difference in interleukin production in different phases of septic patients or between septic and polytrauma group was found. The only parameter that showed correlation with disease severity was the increase in interleukin-6 in final phase of sepsis, which corresponds to septic shock. No significant difference in plasma cytokine levels was found between survival or non-survival septic or polytraumatic patients and the use of carbapenem and cephalosporin. Taken together, the data indicate that, with the exception of interleukin-6, cytokine determination does not serve as marker of infectious disease nor can it be used to predict the prognosis of sepsis.