Association between early detection of soluble TNF-receptors and mortality in burn patients

• Published in: Intensive care medicine 2002-04, Vol.28 (4), p.472-478
• Main Authors: RIBEIRO, C. A, ANDRADE, C, POLANCZYK, C. A, CLAUSELL, N
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Aged; Analysis of Variance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; APACHE; Biological and medical sciences; Biomarkers - blood; Burns; Burns - blood; Burns - mortality; Emergency and intensive care: burns; Endothelin-1 - blood; Female; Hospitals; Humans; Inhalation; Injuries; Intensive care medicine; intervention; Medical sciences; Middle Aged; Mortality; Prospective Studies; Receptors, Tumor Necrosis Factor - blood; surface area; Traumas. Diseases due to physical agents; Tumor Necrosis Factor-alpha - analysis; tumors
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-001-1190-5

To describe early sequential profiling of circulating levels of tumor necrosis factor alpha (TNF-alpha), TNF-1 and TNF-2 soluble receptors (sTNFR1 and sTNFR2), and of endothelin (ET-1) in patients with severe burn injury, and its association with mortality. Prospective study. Intensive Care Burn Unit at a community hospital. Twenty patients with total burn surface area (TBSA)> or = 30%. None. Patients were enrolled within 6 h from the injury. Blood samples were drawn at zero, 6, 12, and 24 h for sequential ELISA measurement of plasma marker levels. Data are expressed as mean+/-SD. Age, TBSA, and inhalation injury were not significantly different between survivors ( n=9; 30+/-13 years, TBSA 40+/-12%) and nonsurvivors ( n=11, 38+/-15 years, TBSA 56+/-20%). sTNFR1 levels were increased in nonsurvivors (2937+/-1676 pg/ml; 4548+/-1436 pg/ml) as compared to survivors (1313+/-561 pg/ml; 2561+/-804 pg/ml) at 6 h and 24 h, respectively ( P=0.01 and 0.002). sTNFR2 levels were significantly increased in nonsurvivors (4617+/-1,876 pg/ml vs 2611+/-1,326 pg/ml) only at 6 h ( P=0.015). TNF-alpha and ET-1 levels were not different between nonsurvivors and survivors. After adjustment for TBSA, sTNFR1 and sTNFR2 remained significantly higher in nonsurvivors. Early and progressive increase in sTNFR1 and sTNFR2 levels is associated with higher risk for poor outcome in severely burned patients.