lnterleukin-8 as a marker of sepsis and its relation to organ SUfunction and patient outcome in the pediatric intensive care

الملخص EN

Background: the diagnosis of sepsis remains elusive and there is a need for biomarkers to help recognition of those critically ill patients, lnterleukin-8 (IL-8) plays an important role in the pathogenesis of sepsis, and is often highly elevated in septic patients. Aims : to evaluate the accuracy of IL-8 serum levels to discriminate patients with sepsis from those with systemic inflammatory response syndrome (SIRS) among critically ill pediatric patients.

Relation of IL-8 serum levels to severity of sepsis and patients' outcome was also assessed. Methods : we conducted a prospective observational study on 64 critically ill patient classified as: SIRS (group A; n = 17), sepsis (group B; n = 28), and severe sepsis (group C; n = 19).

IL-8 was measured on pediatric intensive care unit (PICU) admission (TO) and then after 24 hours (Tl) of admission. Results : in this work, admission (TO) and 24 hour (Tl) plasma levels of IL-8 were significantly increased in septic patients (groups B and C) compared to SIRS patients (group A).

The area under the receiver operating characteristic curve for prediction of sepsis from SIRS was 0.870 for IL-8 (TO); a cut-off value of 198.34 pg / ml had 78.3% sensitivity, and 81.2% specificity.

IL-8 levels (TO) and (Tl) were significantly increased in non-survivors, and increase in serum IL-8 (Tl) level following admission may be associated with mortality.

Admission levels of IL-8 were significantly increased in group A and B patients who went to develop the two or more organ failure within the first 48 hours of PICU admission.

Conclusion: Admission levels of IL-8 could be used to discriminate septic patients and correlate with disease severity; highest levels of IL-8 were associated with development of organ failure and mortality in the PICU.