Early cytokine response to multiple injury.

Serial measurements of the inflammatory cytokines interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF alpha) were made in four patients with multiple injuries to characterize secretion patterns and to relate them to severity of injury and degree of haemorrhage. IL-6 and TNF alpha were assayed using a sandwich ELISA. Injury scores varied from 9 to 50, and transfusion requirements varied from 7 to 14 units. All patients showed an increase in IL-6 but only one a rise in TNF alpha. There was no consistent pattern in the elevation of IL-6 and there was no relation between cytokine levels, severity of injury, transfusion requirement or ultimate outcome. From this preliminary study it would seem that measurement of IL-6 and TNF alpha is not of value in directing therapeutic decisions or as a predictor of outcome.