The features оf immunopathogenesis of sepsis and immunodiagnostics in severely burned patients

Abstract

Intention. To study the possibility of predicting early burn sepsis based on the content of proinflammatory cytokines in the peripheral blood of patients with extensive burns.Methodology. The study included 60 patients (of them 37 men) aged 21 to 58 years (mean age 46.8 ± 9.3 years) with extensive skin burns (Degree III burns by ICD 10 from 20 to 60 %, average 34.1 %, of the body surface). Depending on the skin area affected and the course of burn disease, the patients were divided into three groups, each of 20 patients: group 1 - the course of burn disease without early sepsis, burn area from 21 to 40 % of the body surface; group 2 - the course of burn disease without early sepsis, burn area from 41 to 60 % of the body surface; group 3 - the early burn sepsis, burn area of 20 to 60 % of the body surface. To achieve the goal of the study, all the patients underwent sequential peripheral blood sampling 24 and 72 hours after a burn injury. The levels of IL-1β, IL-6, IL-10, and TNFa were analyzed in the obtained samples. Data were processed using Microsoft Office Excel 2007 and IBM SPSS 20.0 by methods of descriptive and non-parameter statisticsResults and Discussion. The analyzed indicators statistically significantly correlated with the severity of burn injury and the likelihood of burn sepsis. Decreased concentrations of IL-1β, IL-6 and TNFα within Days 1-3 after getting a burn suggest a relatively favorable course of burn disease. No significant positive dynamics of these laboratory parameters may indicate a high probability of developing early burn sepsis.Conclusion. Concentrations of IL-1β, IL-6 and, especially, TNFα in the peripheral blood make it possible to predict early burn sepsis.