The relatıonshıp between bılırubın levels and cytokınes ın the dıagnosıs of sepsıs

Sensitive and specific laboratory tests are needed to guide clinicians in critical patient groups with systemic inflammatory response syndrome and sepsis where early diagnosis is important, where response to treatment needs to be monitored, and where treatment models need to be changed as necessary.This study was planned to be able to find a marker that could describe the cycle at an early phase during the dynamic process progressing from systemic inflammatory response syndrome to severe sepsis, and reveal the relationship between routinely-used bilirubin, many functions of which are known, with the inflammatory process in humans.Ten demographically-similar patients diagnosed with sepsis in compliance with the ACCP/SCCM consensus conference criteria and ten patients not diagnosed with sepsis at our Intensive Care Unit at the Department of Anesthesiology and Reanimation were included in this study. Taking the period in which they were initially diagnosed in the sepsis group as the basal period, IL-6, IL-10, total bilirubin, direct bilirubin, and indirect bilirubin were analyzed from blood samples taken in the 0th (T0), 24th (T1), and 48th (T2) hours. The patients? APACHE and SOFA scores were calculated again in the same sampling periods. And in the control group, the initial blood collection period was considered as the basal period and IL-6, IL-10, total bilirubin, direct bilirubin, indirect bilirubin were analyzed from samples taken in the 0th, 24th, and 48th hours. The patients? APACHE and SOFA scores were calculated again in the sampling periods.We observed that in patients with sepsis included in the study bilirubin, IL-6 and IL-10 levels increased markedly by time, and that this increase was correlated with the APACHE and SOFA scores. We believe that this increase could be associated with early diagnosis in sepsis and the poor prognosis of the disease. We conclude that this increase in bilirubin and cytokine levels could be used in projecting the steps of the inflammatory process in sepsis and associated clinical patterns, but further studies on the subject with more patients are needed.Key Words: Sepsis, IL-6, IL-10, Bilirubin