CHANGES IN SKELETAL-MUSCLE PO2 AFTER ADMINISTRATION OF ANTI-TNF-ALPHA-ANTIBODY IN PATIENTS WITH SEVERE SEPSIS - COMPARISON TO INTERLEUKIN-6SERUM LEVELS, APACHE-II, AND ELEBUTE SCORES

In 20 patients with severe sepsis, skeletal muscle pO2 was continuousl y measured in order to assess whether a decrease of skeletal muscle pO 2 was accompanied by an improvement of sepsis after repeated administr ation of F(ab'), fragments of a murine anti-TNFalpha-antibody. Abnorma lly high skeletal muscle pO2 decreased from 43.5 +/- 10.9 mmHg (day 0) to 36.4 +/- 10.1 mmHg within 24 h after the first administration of a nti-TNFalpha-antibody (day 1, p = .006, n = 20) and remained at 34.6 /- 7.7 mmHg thereafter (mean day 2-7, p = .004). The decrease of skele tal muscle pO2 within 24 h exceeded 5 mmHg (-7 to -19 mmHg) in 11 pati ents in contrast to nine patients (-4 to +4 mmHg). Only in the patient s showing a decrease of skeletal muscle pO2 did sepsis improve as dete rmined by Elebute score, APACHE II score, and interleukin-6 serum leve ls. The change of skeletal muscle pO2 within 24 h was associated with a change of interleukin-6 serum levels within 24 h (r = .5, n = 20), w ith a change of Elebute score (r = .7, n = 20) and of APACHE II score (r = .62). These data suggest that a decrease of skeletal muscle pO2 m ight be an early indicator of improvement of sepsis after administrati on of anti-TNFalpha-antibodies.