Critical Care and Emergency Center, Iwate Medical University, 19-1 Uchimaru, Morioka 020, Japan
Department of Critical Care Medicine, Akita University Medical School, 1-1-1 Hondo, Akita 010, Japan
Department of Bacteriology, Iwate Medical University Medical School, 19-1 Uchimaru, Morioka 020, Japan
Object
We measured endotoxins, inflammatory cytokines and soluble adhesion molecules in the blood of 17 severe burn patients to determine the involvement of these factors in the pathophysiology in burn patients.
Design
Prospective study.
Patients
Seventeen patients with burns with a total burn surface area of 20% or more and a burn index of 15% or more.
Measurement and main results
Endotoxin was measured by an endotoxin-specific assay. Tumor necrosis factor-α, interleukin 6 and interleukin 8 were measured by an enzyme-linked immunosorbent assay. Soluble adhesion molecules were also measured by an enzyme-linked immunosorbent assay. CD11a, CD11b, and CD18 were measured by a flow cytometry. Their levels were high in the non-surviving group, the septic shock group, and the multiple organ dysfunction syndrome group, suggesting the possibility of a close connection between them and the evolution of the pathophysiology in patients with burns complicated by infection (Table).
Conclusion
Soluble adhesion molecules were found to indirectly reflect the level of endothelial cell adhesion molecules, suggesting that inflammatory cytokines may also be involved as factors in their production.
Comparisons of the factors in the sepsis group and the sepsis-free group
Sepsis (-) (
Sepsis (+) (
Endotoxin (pg/ml)
8.1 ± 10.1
12.5 ± 8.8
0.1630
TNF-α (pg/ml)
74.5 ± 58.7
638.1 ± 792.7
0.0151
IL-6 (pg/ml)
65.3 ± 112.4
754.9 ± 862.1
0.0346
IL-8 (pg/ml)
83.9 ± 11.7
280.9 ± 114.8
0.0168
slCAM-1 (ng/ml)
682.1 ± 291.3
924.6 ± 542.1
0.0362
sELAM-1 (ng/ml)
261.7 ± 23.0
342.1 ± 53.4
0.0101
sVCAM-1 (ng/ml)
1245.1 ± 422.6
3028.9 ± 1861.2
0.0438