INFLUENCE OF PENTOXIFYLLINE ON CYTOKINE LEVELS AND INFLAMMATORY PARAMETERS IN SEPTIC SHOCK

Citation
T. Staudinger et al., INFLUENCE OF PENTOXIFYLLINE ON CYTOKINE LEVELS AND INFLAMMATORY PARAMETERS IN SEPTIC SHOCK, Intensive care medicine, 22(9), 1996, pp. 888-893
Citations number
47
Categorie Soggetti
Emergency Medicine & Critical Care
Journal title
ISSN journal
03424642
Volume
22
Issue
9
Year of publication
1996
Pages
888 - 893
Database
ISI
SICI code
0342-4642(1996)22:9<888:IOPOCL>2.0.ZU;2-A
Abstract
Objective: To evaluate the influence of pentoxifylline (PTX), a phosph odiesterase inhibitor, on cytokines and inflammatory proteins in patie nts suffering from septic shock. Design: Prospective study comparing a therapy group to a matched control group. Setting. Medical intensive care unit at a university hospital. Patients: Twenty four patients ful filling the criteria of septic shock were included in this study. Twel ve patients received PTS (therapy group) and 12 patients matched for d iagnosis, age and gender served as the control group. Interventions: P entoxifylline at 1 mg/kg per hour over 24 h in the therapy group. Meas urements and results: Cytokine levels [tumor necrosis factor-alpha (TN F)], soluble TNF receptor [TNF-R], and interleukin-6 [IL-6] and inflam matory proteins [C-reactive protein, alpha-1-antitrypsin (AAT), fibron ectin, and haptoglobin], as well as hemodynamic parameters and the APA CHE III score were evaluated before initiation of therapy and 24 h lat er. After 24 h, TNF levels were significantly lower in the therapy gro up (p = 0.013), while IL-6 levels were significantly higher in the the rapy group (p = 0.030). Within the 24 h TNF declined significantly in the therapy group (p = 0.006), while IL-6 showed a significant increas e (p = 0.043). AAT and the APACHE III score tended to differ significa ntly after 24 h between the groups [AAT levels higher in the therapy g roup (p = 0.05), APACHE III score lon er (p = 0.05)]. In the therapy g roup, the systemic vascular resistance index was significantly higher after 24 h (p = 0.0026) whereas the cardiac index declined (p = 0.035) . Conclusions: PTX does influence TNF levels in septic shock patients. Nevertheless, inhibiting a single mediator in severe septic shock can not stop the inflammatory overreaction.