Characteristics of plasma TNF-α and Interleukin-6 concentrations at the time of diagnosis of septic shock in severe burn patients

Ngo Tuan Hung1,2,, Nguyen Nhu Lam1,2, Nguyen Hai An2,3, Tran Dinh Hung1,2, Do Minh Trung4, Nguyen Van Dong2, Lai Thi Nga2, Nguyen Thi Mai Huong2
1 Burns and Disaster Medicine Department, Vietnam Military Medical University
2 Le Huu Trac National Burn Hospital
3 Bộ môn Bỏng & Y học Thảm hoạ, Học viện Quân y
4 Military Pharmaco-Medicine Research Institute

Main Article Content

Abstract

Objectives: identify characteristics of plasma TNF-α and interleukin-6 (IL-6) levels in severe burn patients at the time of septic shock diagnosis.
Subjects and methods: Cross-sectional study, descriptive at the time of diagnosis of septic shock in 54 times of septic shock in 37 severe burn patients (16-60 years old), treated at the Intensive Care Unit, Le Huu National Burn Hospital Trac from January 2023 to June 2024.
Results: At the time of diagnosis of septic shock, the SOFA score was 5 points, the APACHE II score was 20.82 points, and the number of failed organs was 1.51 organs; TNF-α and IL-6 concentrations were elevated (TNF-α: 20.54pg/mL (12.76 - 40.44pg/mL); IL -6: 645.45pg/mL (244.81 - 1011.28pg/mL). For every 10pg/mL increase in TNF-α, the risk of SOFA score increased by 0.2 times, MAP and ScvO2 decreased by 0.3 and 1.4 times, respectively (p < 0.05); for every 10pg/mL increase in IL-6, MAP and ScvO2 risk decreased by 0.04 times and 0.2 times, respectively (p < 0.01), arterial lactate increases by 0.01 times (p < 0.01).
Compared with septic shock patients with negative blood cultures, blood culture-positive septic shock patients had significantly higher plasma TNF-α and IL-6 concentrations at the time of septic shock diagnosis (p < 0.05). Plasma IL-6 concentration at the time of diagnosis of septic shock has a fairly good predictive value for positive blood cultures. The Hosmer - Lemeshow test showed that the regression equation was suitable for positive blood cultures (p > 0.05).
Conclusion: Plasma TNF-α and IL-6 concentrations were elevated in severe burn patients at the time of diagnosis of septic shock. The predictive value of positive blood culture of plasma IL-6 concentration was quite good in severe burn patients with septic shock.

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References

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