Quantification of cytokine mRNA levels, procalcitonin and lactate in septic patients as a prognostic value to determine complicated sepsis

HUESPE, LUIS; MELANA COLAVITA, JUAN PABLO; STOYANOFF, TANIA; BARNES, TAMARA; AGUIRRE, MARÍA VICTORIA; RODRÍGUEZ, JUAN PABLO

Sao Paulo

Congreso; XV Forum Internacional de Sepsis; 2018

ObjectiveThis study aimed to investigate the potential use of cytokines as biomarkers to distinguish patients progressing to severe sepsis from those with uncomplicated sepsis.MethodsPatients diagnosed with sepsis-3 were admitted to this study, in the period December 2017 - April 2018. Epidemiological data, SOFA, APACHEII, procalcitonin, lactate, primary site of infection, microbiological culture, days of ventilation and standard care were determined. Biomarkers cut-off and 28 days-mortality were established. This study was approved by the institutional committee for medical research of the San Martín Hospital School. Arterial blood was taken from all patients with shock septic, and their PBMCs were isolated using Hypaque-Ficoll Plus. TriReagent (Ambion) kit was used for the extraction of RNA and Ultra-Fast SYBR® Green commercial kit was used for qPCRs. The relative expression of each mRNA was calculated by the ΔΔCt method.ResultsPatients (n=152) were admitted to ICU, and 25 of them were diagnosed with Sepsis-3. The average data were: Age 40.4 years (20-81 years), SOFA 6.4 (1-13), APACHEII 15.8 (9-34), Procalcitonin 11.59 ng / dl (0.7-100 ng / dl), Ventilation 7.52 days. Overall mortality 13 patients (52%, 8 patients with Lactate> 4 mM and 5 patients with Lactate between 2 and 4 mM). RT-qPCR analysis revealed that proinflammatory cytokines (like IL1, IL6, IL12, TNF and IL18 show significant increases in all patients (P