Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Aug 4, 2016; 5(3): 187-200
Published online Aug 4, 2016. doi: 10.5492/wjccm.v5.i3.187
Predictive value of cytokines for developing complications after polytrauma
Anne-Britt E Dekker, Pieta Krijnen, Inger B Schipper
Anne-Britt E Dekker, Pieta Krijnen, Inger B Schipper, Department of Trauma Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
Author contributions: This study represents a great deal of effort, resources and dedication on the part of the authors in reviewing the literature and performing statistical analyses; all authors have participated in a material way to at least three of the following elements: Study design, gathered data, analysed data, initial draft, ensured accuracy of data; all authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
Data sharing statement: The technical appendix including the full search strategy for this systematic review is available from the corresponding author at A.E.Dekker@lumc.nl. Since this study did not involve any biostatistics, no statistical code and dataset are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Anne-Britt E Dekker, MD, Department of Trauma Surgery, Leiden University Medical Center, Postal Zone K6-R, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. a.e.dekker@lumc.nl
Telephone: +31-71-5261065 Fax: +31-71-5266750
Received: February 23, 2016
Peer-review started: February 25, 2016
First decision: March 24, 2016
Revised: April 8, 2016
Accepted: April 21, 2016
Article in press: April 22, 2016
Published online: August 4, 2016
Abstract

AIM: To investigate posttraumatic cytokine alterations and their value for predicting complications and mortality in polytraumatized patients.

METHODS: Studies on the use of specific cytokines to predict the development of complications and mortality were identified in MEDLINE, EMBASE, Web of Science and the Cochrane Library. Of included studies, relevant data were extracted and study quality was scored.

RESULTS: Forty-two studies published between 1988 and 2015 were identified, including 28 cohort studies and 14 “nested” case-control studies. Most studies investigated the cytokines interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor (TNF-α). IL-6 seems related to muliorgan dysfunction syndrome, multiorgan failure (MOF) and mortality; IL-8 appears altered in acute respiratory distress syndrome, MOF and mortality; IL-10 alterations seem to precede sepsis and MOF; and TNF-α seems related to MOF.

CONCLUSION: Cytokine secretion patterns appear to be different for patients developing complications when compared to patients with uneventful posttraumatic course. More research is needed to strengthen the evidence for clinical relevance of these cytokines.

Keywords: Multiple trauma, Cytokine, Acute respiratory distress syndrome, Sepsis, Muli-organ dysfunction syndrome, Multi-organ failure

Core tip: Early identification of patients at risk for developing complications is one of the most challenging problems in the therapy of multiple injuries. Close monitoring of cytokine secretion patterns could give physicians an impression of the individual risk for development of complications. Further, physicians are directed to the appropriate prophylactic treatment, as well as optimal timing of surgical interventions, thereby reducing “second hits” with subsequent risks of development of sepsis and multiorgan failure. This article provides an overview of the results from literature concerning posttraumatic immune alterations leading to various complications and death.