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The involvement of cytokines in trauma still has not been satisfactorily elucidated. The development of multiorgan failure, the very serious complication of multiple trauma with high mortality, should also be controlled by cytokines, endotoxin, and other mediators. We therefore prospectively studied 42 consecutive patients with multiple trauma admitted from June to December 1992 to the Research Institute for Traumatology and Surgery in Brno. Study patients were characterized by Injury Severity Score (ISS), Revised Trauma Score, and TRISS methodology. In all patients, tumor necrosis factor alpha (TNF-alpha) and interleukin (IL) 1, 2, and 6 levels were investigated. Of the cytokines, only IL-6 levels were elevated at admission and significant correlation with ISS was observed (r = 0.735; p 400 pg/mL survived. In conclusion, the IL-6 and TNF-alpha levels seem to play a significant role in multiple trauma and their late elevation in patients with MOF conveyed a poor prognosis. A significant correlation between initial IL-6 levels and ISS was observed. Other cytokines did not show dynamic changes during the study.
Svoboda et al. (Tue,) studied this question.