Fluid Balance, Interferon-Gamma, Interleukin- 12 and Tumor Necrosis as predictive factors of Survival in Severe Sepsis

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Fluid Balance, Interferon-Gamma, Interleukin- 12 and Tumor Necrosis as predictive factors of Survival in Severe Sepsis

Journal Title: SAINS MEDIKA (Journal of Medicine and Health) - Year 2012, Vol 4, Issue 1

Abstract

Background: The cardiovascular derangements of severe sepsis in human include arteriolar, venular dilation, capillary leak, and immunomodulatory response. Intravascular volume replacement during resuscitation most frequently converts the circulation to a high-out put hypotensive state. We hypothesized that patients with severe sepsis had any predicting factors to survive than those who do not. Design and Method: Randomized Clinical Trials were conducted of 110 patients suffered from severe sepsis in ICU/HCU. Admission APACHE II, SOFA scores, IFN- , IL-12, TNF-α, and fluid balance were computed from the extracted data. Patients allowed to severe sepsis treatment according with the International Consensus Committee. Summary estimates using both the Mantel-Haenszel test and precision based approaches were computed for statistical analysis. Result: Of 110 patients ranged in age from 46 to 71 years with a mean (± SE) age of 63.45 ± 3.97 years. The mean admission APACHE II score was 25.96 ± 3.65; and the day 1 SOFA score was 9.57 ± 1.24. Twenty one patients did not survive, Non-survival had higher mean APACHE II than survivals (29.85 vs 20.46), respectively (p < 0.01). Higher first day IFN- , IL-12, TNF-α, and SOFA scores (p< 0.01). Whereas 26 patients who achieved a negative fluid balance of > 500 mL on > of the first 3 days of treatment survived (RR 5.0; 95% CI : 2.3 to 10.7, p < 0.0001). Conclusion: These results suggest that at least 1 day of negative fluid balance (<-500mL), IFN- , IL-12, and TNF-α may be a good independent predictors of survival in patients with severe sepsis. These findings suggest the hypothesis that four independent predictors of severe sepsis portend a good prognosis for a larger prospective study (Sains Medika, 4(1):13-22).

Authors and Affiliations

Djoko Trihadi Lukmono Subagyo

Keywords

Hypertension: Dominant Risk Factor on Stroke Occurence Analytical Observational Study in Sultan Agung Islamic Hospital Semarang during January 1, 2012 - August 31, 2013

Introduction: Stroke ranks as the first cause of disabilities and the third cause of death in the world. Many factors associated with stroke. Objective: this study aimed at evaluating the factors associated with stroke....

EP ID EP234333
DOI -
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