Plasma tumor necrosis factor in patients with septic shock. Mortality rate, incidence of adult respiratory distress syndrome, and effects of methylprednisolone administration

Am Rev Respir Dis. 1990 Jan;141(1):94-7. doi: 10.1164/ajrccm/141.1.94.

Abstract

We assayed serial plasma samples from 86 patients, who were enrolled in a prospective randomized trial of the effects of methylprednisolone (MPSS) in septic shock, for the presence of cytokine tumor necrosis factor (TNF) using an enzyme-linked immunosorbent assay. TNF was present in the plasma of 27 of the 74 patients with septic shock, but in only 1 of the 12 patients with shock due to other causes. TNF was detected with equal frequency in patients with shock from gram-negative or from gram-positive bacillary sepsis. TNF levels were highest on the initial sample and decreased significantly over the subsequent 24 h in both the patients treated with MPSS and in those given placebo. Patients with detectable TNF had a higher incidence and severity of the adult respiratory distress syndrome and a higher mortality rate than did patients without detectable TNF.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Humans
  • Methylprednisolone / therapeutic use*
  • Respiratory Distress Syndrome / etiology*
  • Shock / blood
  • Shock, Septic / blood*
  • Shock, Septic / complications
  • Shock, Septic / drug therapy
  • Shock, Septic / mortality
  • Time Factors
  • Tumor Necrosis Factor-alpha / analysis*

Substances

  • Tumor Necrosis Factor-alpha
  • Methylprednisolone