Cytokines and Metabolic Patterns in Pediatric Patients with Critical Illness
It is not known if cytokines, which are cell-derived mediators released during the host immune response to stress, affect metabolic response to stress during critical illness. The aim of this prospective study was to determine whether the metabolic response to stress is related to the inflammatory i...
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Wiley
2010-01-01
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| Series: | Clinical and Developmental Immunology |
| Online Access: | http://dx.doi.org/10.1155/2010/354047 |
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| author | George Briassoulis Shekhar Venkataraman Ann Thompson |
| author_facet | George Briassoulis Shekhar Venkataraman Ann Thompson |
| author_sort | George Briassoulis |
| collection | DOAJ |
| description | It is not known if cytokines, which are cell-derived mediators released during the host immune response to stress, affect metabolic response to stress during critical illness. The aim of this prospective study was to determine whether the metabolic response to stress is related to the inflammatory interleukin-6 (IL-6), 10 (IL-10), and other stress mediators' responses and to assess their relationships with different feeding patterns, nutritional markers, the severity of illness as assessed by the Multiple Organ System Failure (MOSF), the Pediatric Risk of Mortality Score (PRISM), systemic inflammatory response syndrome (SIRS), and mortality in critically ill children. Patients were classified as hypermetabolic, normometabolic, and hypometabolic when the measured resting energy expenditures (REE) were >110%, 90–110% and, <90% of the predicted basal metabolic rate, respectively. The initial predominance of the hypometabolic pattern (48.6%) declined within 1 week of acute stress (20%), and the hypermetabolic patterns dominated only after 2 weeks (60%). Only oxygen consumption (VO2) and carbon dioxide production (VCO2) (𝑃<.0001) but none of the cytokines and nutritional markers, were independently associated with a hypometabolic pattern. REE correlated with the IL-10 but not PRISM. In the presence of SIRS or sepsis, CRP, IL-6, IL-10, Prognostic Inflammatory and Nutritional Index (NI), and triglycerides—but not glucose, VO2, or VCO2 increased significantly. High IL-10 levels (𝑃=.0000) and low measured REE (𝑃=.0000) were independently associated with mortality (11.7%), which was higher in the hypometabolic compared to other metabolic patterns (𝑃<.005). Our results showed that only VO2 and VCO2, but not IL-6 or IL-10, were associated with a hypometabolic pattern which predominated the acute phase of stress, and was associated with increased mortality. Although in SIRS or sepsis, the cytokine response was reliably reflected by increases in NI and triglycerides, it was different from the metabolic (VO2, VCO2) or glucose response. |
| format | Article |
| id | doaj-art-441de8ef334949c89f7813e5ba35af7e |
| institution | Kabale University |
| issn | 1740-2522 1740-2530 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
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| series | Clinical and Developmental Immunology |
| spelling | doaj-art-441de8ef334949c89f7813e5ba35af7e2025-02-03T05:48:10ZengWileyClinical and Developmental Immunology1740-25221740-25302010-01-01201010.1155/2010/354047354047Cytokines and Metabolic Patterns in Pediatric Patients with Critical IllnessGeorge Briassoulis0Shekhar Venkataraman1Ann Thompson2Division of Pediatric Critical Care Medicine, Children's Hospital of Pittsburgh of UPMC, 3705 Fifth Avenue, Pittsburgh, PA 15213, USADivision of Pediatric Critical Care Medicine, Children's Hospital of Pittsburgh of UPMC, 3705 Fifth Avenue, Pittsburgh, PA 15213, USADivision of Pediatric Critical Care Medicine, Children's Hospital of Pittsburgh of UPMC, 3705 Fifth Avenue, Pittsburgh, PA 15213, USAIt is not known if cytokines, which are cell-derived mediators released during the host immune response to stress, affect metabolic response to stress during critical illness. The aim of this prospective study was to determine whether the metabolic response to stress is related to the inflammatory interleukin-6 (IL-6), 10 (IL-10), and other stress mediators' responses and to assess their relationships with different feeding patterns, nutritional markers, the severity of illness as assessed by the Multiple Organ System Failure (MOSF), the Pediatric Risk of Mortality Score (PRISM), systemic inflammatory response syndrome (SIRS), and mortality in critically ill children. Patients were classified as hypermetabolic, normometabolic, and hypometabolic when the measured resting energy expenditures (REE) were >110%, 90–110% and, <90% of the predicted basal metabolic rate, respectively. The initial predominance of the hypometabolic pattern (48.6%) declined within 1 week of acute stress (20%), and the hypermetabolic patterns dominated only after 2 weeks (60%). Only oxygen consumption (VO2) and carbon dioxide production (VCO2) (𝑃<.0001) but none of the cytokines and nutritional markers, were independently associated with a hypometabolic pattern. REE correlated with the IL-10 but not PRISM. In the presence of SIRS or sepsis, CRP, IL-6, IL-10, Prognostic Inflammatory and Nutritional Index (NI), and triglycerides—but not glucose, VO2, or VCO2 increased significantly. High IL-10 levels (𝑃=.0000) and low measured REE (𝑃=.0000) were independently associated with mortality (11.7%), which was higher in the hypometabolic compared to other metabolic patterns (𝑃<.005). Our results showed that only VO2 and VCO2, but not IL-6 or IL-10, were associated with a hypometabolic pattern which predominated the acute phase of stress, and was associated with increased mortality. Although in SIRS or sepsis, the cytokine response was reliably reflected by increases in NI and triglycerides, it was different from the metabolic (VO2, VCO2) or glucose response.http://dx.doi.org/10.1155/2010/354047 |
| spellingShingle | George Briassoulis Shekhar Venkataraman Ann Thompson Cytokines and Metabolic Patterns in Pediatric Patients with Critical Illness Clinical and Developmental Immunology |
| title | Cytokines and Metabolic Patterns in Pediatric Patients with Critical Illness |
| title_full | Cytokines and Metabolic Patterns in Pediatric Patients with Critical Illness |
| title_fullStr | Cytokines and Metabolic Patterns in Pediatric Patients with Critical Illness |
| title_full_unstemmed | Cytokines and Metabolic Patterns in Pediatric Patients with Critical Illness |
| title_short | Cytokines and Metabolic Patterns in Pediatric Patients with Critical Illness |
| title_sort | cytokines and metabolic patterns in pediatric patients with critical illness |
| url | http://dx.doi.org/10.1155/2010/354047 |
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