EVOLUTION AND SIGNIFICANCE OF CIRCULATING PROCALCITONIN LEVELS COMPARED WITH IL-6, TNF-ALPHA AND ENDOTOXIN LEVELS EARLY AFTER THERMAL-INJURY

To determine the evolution and significance of circulating procalciton in (ProCT), IL-6, TNF alpha and endotoxin levels early after thermal i njury, we performed a prospective, single unit, longitudinal study. Fo rty burn patients with total body surface area (TBSA) >30 per cent wer e studied, of whom 33 suffered an inhalation injury. Blood samples wer e taken on the day of admission, every 4 h during the first day and da ily during the first week. All patients had increased ProCT and IL-6 l evels without any proven infection. Endotoxin and TNF alpha levels rem ained very law or undetectable. ProCT and IL-6 levels correlated well with the severity of skin burn injury (respectively, p<0.006 and p<0.0 28, using the non-parametric Kruskal-Wallis test). ProCT levels are no t associated with smoke inhalation. ProCT and IL6 are prognostic facto rs of mortality at the time of admission but less reliable than the cl inical UBS (unit burn standard) score. Endotoxin and TNF alpha were un detectable suggesting that the problem of the early gut bacterial tran slocation remains to be proven. (C) 1997 Elsevier Science Ltd for ISBI .