Assessment of inflammatory cytokines, nitrate/nitrite, type II phospholipase A2, and soluble adhesion molecules in systemic inflammatory response syndrome.

Plasma endotoxin levels, nitrate/nitrite (NOx), type II phospholipase A2 (PLA2), soluble adhesion molecules, and inflammatory cytokines were measured in 34 patients with systemic inflammatory response syndrome (SIRS). Significant correlations were found between NOx values, PLA2 values, soluble adhesion molecules, and inflammatory cytokines, suggesting the possibility that these factors were deeply affected each other. When the 34 SIRS patients were divided into the group with sepsis (n = 20) and with the group with trauma without documented infection (n = 14), despite the fact that the difference in APACHE II scores was not significant, all of the factors except endotoxin were significantly higher in the sepsis group than in the trauma group, and the outcome was death in 4 of the 14 patients in the trauma group (28.6%), as opposed to 14 of the 20 patients in the sepsis group (70.0%). The mediator values measured in this study seemed to reflect the difference in the severity of the patients' disease and their outcome.