Some Aspects of Formation of a Systemic Inflammatory Response in Critically Ill Patients

Abstract

Objective: to study the general regularities and pathogenetic significance of changes in primary and secondary inflammatory mediator ratios in the formation of a systemic inflammatory response in critically ill patients. Subjects and methods. Three hundred and eighty-seven critically ill inpatients from intensive care units were examined. Results. The systemic inflammatory response syndrome develops in critical conditions, which is characterized by the increased serum levels of primary (proinflammatory cytokines) and secondary (C-reactive protein, fibrinogen) inflammatory mediators, which was more substantial in infected patients. When the hyperproduction of proinflammatory cytokines was evident, there was no adequate proinflammatory response, as suggested by the negative IL-10 level changes. Correlations were established between the serum content of inflammatory mediators and the indices of external respiration function, respiration rate, and heart rate. Conclusion. The nature of changes in the quantitative (mediator concentrations) and qualitative (mediator ratio) indices enables one to estimate the intensity of a systemic inflammatory response and to predict its further progression. Key words: critical condition, systemic inflammatory response, inflammatory mediators.