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Multiple organ failure in patients with cardiogenic shock is associated with high plasma levels of interleukin-6

Geppert, Alexander MD; Steiner, Angela; Zorn, Gerlinde; Delle-Karth, Georg MD; Koreny, Maria MD; Haumer, Markus MD; Siostrzonek, Peter MD; Huber, Kurt MD; Heinz, Gottfried MD

Critical Care Medicine:
Clinical Investigations
Abstract

Objective: In patients with septic shock, multiple organ failure (MOF) is associated with high levels of interleukin-6 (IL-6). Although organ failure is also a common complication of cardiogenic shock (CS), IL-6 levels have been reported to be lower in patients with CS than in patients with septic shock. We studied IL-6 plasma levels in patients with CS with respect to organ failure.

Setting: Eight-bed intensive care unit at a university hospital.

Patients: Fifty-one patients with CS, 26 patients with septic shock, and 11 noncritically ill controls.

Interventions: None.

Measurements and Main Results: Patients with CS had higher IL-6 levels than noncritically ill controls (p < .001) but lower levels than patients with septic shock (p = .003). CS patients with MOF at the time of blood sampling exhibited, however, higher IL-6 levels than CS patients without organ failure, and IL-6 levels in patients with CS correlated to the total Sepsis-related Organ Failure Assessment score at the time of blood sampling (r = .57, p < .001). No significant differences in IL-6 levels were found when comparing CS patients with MOF at the time of blood sampling with patients with septic shock. Furthermore, CS patients who developed MOF during ICU stay exhibited significantly higher IL-6 levels than CS patients who never did develop MOF. An IL-6 level of >200 pg/mL had a 93% specificity and 100% sensitivity for the prediction of MOF in patients with CS.

Conclusions: Once MOF is present, patients with CS exhibit similarly high IL-6 levels as patients with septic shock. High IL-6 levels in CS patients are associated with a progression to MOF.

Author Information

From the Department of Cardiology, Intensive Care Unit (AG, AS, GDK, MK, GH), the Department of Cardiology (GZ, PS, KH), and the Department of Angiology (MH), University of Vienna, Austria.

Our data show that elevations in interleukin-6 are frequently encountered in patients with cardiogenic shock and that once multiple organ failure is present, patients with cardiogenic shock exhibit similarly high interleukin-6 levels as patients with septic shock.

© 2002 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins