Integral estimation of systemic inflammatory response under sepsis.

Abstract

Currently, the most significant mediators of the systemic inflammatory response (SIR), specific to the development of critical states in sepsis, have the chaotic changes of concentrations in the blood. The solution to the problem is using integral indicators. A scoring scale of the SIR (0-16 points) is proposed based on the determination in the blood plasma of CRP, TNF-α, IL-6, IL-8 and IL-10. The scale was used in the survey of 167 patients with a diagnosis of sepsis (43 patients with sepsis according to definitions of "Sepsis-1 or 2" and 124 patients with sepsis according to the criteria of "Sepsis-3"); septic shock was verified in 31 cases and in 48 cases lethal outcomes were recorded. The association of SIR with critical complications of sepsis was revealed, especially under acute septic shock and in cases of a "second wave" (days 5-7) of critical complications. In contrast, prolonged/subacute sepsis (more than 14 days) under tertiary peritonitis is characterised by a lesser dependence of the criticality of the state on the severity of SIR. The proposed scale is an open system and allows you to modify the range of used particular indicators that are compatible by pathogenetic and diagnostic significance.