Cytokine elevations in critically ill infants with sepsis and necrotizing enterocolitis☆,☆☆,★
Section snippets
Study population
All neonates with suspected sepsis who were hospitalized in the infant intensive care unit of Children's Hospital of Philadelphia during the 36-month period beginning in April 1989 were eligible for enrollment in the study. Inclusion criteria included all of the following: (1) a risk factor for infection, (2) physical examination demonstrating either respiratory or circulatory dysfunction, and (3) physical signs of infection.
A risk factor for infection included at least one of the following:
Study population
Sixty-two infants with suspected sepsis who met inclusion criteria were enrolled. These infants had a birth weight of 1.6 ± 0.95 kg (mean ± SD) and a mean gestational age of 30 weeks (range 22 to 41 weeks). Among the entire group of study infants 73% were premature, 58% had been hospitalized >7 days, and 81% had a foreign body in place (endotracheal tube, chest tube, or ventriculoperitoneal shunt, including 10% with central intravascular catheters) at the time of enrollment. Ninety-eight
DISCUSSION
Previous studies in adults have implicated the cytokines TNF, IL-1, and IL-6 as important endogenous mediators in the pathogenesis of sepsis and shock.6, 7, 8, 9 Several studies have demonstrated elevated TNF levels in adults with bacterial sepsis, which correlated with mortality rates.6, 7 Similarly, Waage et al.9 and Hack et al.10 demonstrated increased levels of IL-6 in the plasma of adults with bacterial sepsis, and these were associated with an increased incidence of shock and death.
Data
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Cited by (188)
Interleukin-6 serum levels predict surgical intervention in infants with necrotizing enterocolitis
2019, Journal of Pediatric SurgeryChanging the paradigm of defining, detecting, and diagnosing NEC: Perspectives on Bell's stages and biomarkers for NEC
2018, Seminars in Pediatric SurgeryGenetic Basis of Necrotizing Enterocolitis
2018, Hematology, Immunology and Genetics: Neonatology Questions and ControversiesThe Microbiome and Biomarkers for Necrotizing Enterocolitis: Are We Any Closer to Prediction?
2017, Journal of PediatricsCytokines and growth factors in the developing intestine and during necrotizing enterocolitis
2017, Seminars in Perinatology
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From the Division of Neonatology, the Division of Allergy, Immunology and Infectious Diseases, the Department of Pediatrics, and the Department of Anesthesia and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia
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Reprint requests: Mary Catherine Harris, MD, Division of Neonatology, Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd., Philadelphia, PA 19104.
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0022-3476/94/$1.00 + .10 9/23/50952