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Table 3 Clinical studies and animal models evaluating longitudinal cytokine response to trauma

From: The impact of septic stimuli on the systemic inflammatory response and physiologic insult in a preclinical non-human primate model of polytraumatic injury

 

IL-6

IL-10

TNF

Study (reference #)

Injury/Insult, n

Mean Peak (pg/mL)

Time Point

Mean Peak (pg/mL)

Time Point

Mean Peak (pg/mL)

Time Point

Kubiak 2011 [20]

Animal (Insult): Swine (Trauma, IRI, Sepsis)

Survival: 48 h

Trauma (laparotomy) + IRI (SMA clamp ×  30 min) + Sepsis (fecal clot) with passive drainage at 12 h. n = 5

23,702

36 h

163

6 h

852

48 h

Kinasewitz 2000 [30]

Animal(Insult): NHP (Trauma, Sepsis)

Survival: 14 days

Trauma (laparotomy), Sepsis (E coli fibrin clot peritonitis). n = 5 (non-survivor)

~ 22,000

4 h

  

~ 31,000 (death)

2 h

Trauma (laparotomy), Sepsis (E. coli fibrin clot peritonitis). n = 4 (signs of sepsis)

~ 22,000

4 h

  

~ 12,000 (sepsis)

2 h

Trauma (laparotomy), Sepsis (E. coli fibrin clot peritonitis). n = 4 (well appearing)

~ 10,000

4 h

  

~ 12,000 (well)

2 h

Martin 1997 [21]

Clinical Study (Sepsis vs. Trauma and Survivors vs. Nonsurvivors) and (Sepsis vs. Trauma and Hemorrhage)

Septic Shock (mean APACHE II score = 27) non-survivors n = 14

15,627

arrival

  

34

9th blood draw

Septic Shock (mean APACHE II score = 27) survivors n = 11

~ 4000

arrival

  

~ 20

3rd blood draw

Trauma (mean ISS = 27) non-survivors n = 7

600

8th blood draw

  

30

blood draw 13

Trauma (mean ISS = 27) survivors n = 53

~ 200

peak

  

~ 20

blood draw 11

Trauma (mean ISS not reported) + Hemorrhagic Shock n = 8

420

2nd blood draw

  

~ 30

8th blood draw

Jastrow 2009 [40]

Clinical Study (Trauma +/− MOF)

Trauma (mean ISS 26) with MOF. n = 11

7179

2–6 h

239

2–6 h

211

2–6 h

Trauma (mean ISS 25) with nonMOF. n = 37

427

6–10 h

15

2–6 h

0

2–6 h

PHM Animal: NHP (Trauma, Hemorrhage, and Sepsis)

Survival: 14 days

Trauma (laparoscopic liver/bowel injury, flank soft tissue injury) + intra-abdominal hemorrhage/ sepsis ×  2 h. n = 20

6860

4 h

13,519

2 h

321

24 h

THM Animal: NHP (Trauma and Hemorrhage) Survival: 14 days

Trauma (laparoscopic liver injury) + Hemorrhage (uncontrolled hemorrhage ×  120 min)n = 5

1168

4 h

588

2 h

2

60 min

Sheppard 2017 [43]

Animal: NHP (Trauma and Hemorrhage)

Survival: 24 h

Trauma (Lapartomy and Femur Fracture) + Decompensated Hemorrhage (pressure controlled)

~ 750

6 h

~ 450

<  6 h

  

Trauma (Laparotomy and Femur Fracture) + 60 min Hemorrhage (Pressure Controlled)

~ 400

6 h

~ 650

<  6 h

  

Deitch 1996 [41]

Animal: NHP (Trauma and Hemorrhage vs. Trauma)

Survival: 8 h

Trauma (neck dissection and partial removal of clavicle) + Hemorrhage (40 mmHg × 3 h or reached -5 mEq Base Excess). n = 5

~ 350

~ 4 h

    

Trauma (neck dissection and partial removal of clavicle)

~ 100

~ 8 h

    

Namas 2009 [38]

Clinical Study (Trauma)

Human Trauma (mean ISS 24) + Hemorrhagic Shock n = 4 (non-survivors)

202a

within 6 h

33a

within 6 h

4a

within 6 h

Baker 2012 [35]

Animal: Swine (Trauma vs. Hemorrhage vs. Trauma and Hemorrhage)

Survival: 300 min

Trauma (femur fracture and lung contusion) + Hemorrhage(20-30 mmHg × 60 min). n = 6

~ 170

2 h

~ 15

baseline

133

baseline

Trauma (femur fracture and lung contusion). n = 5

~ 170

5 h

~ 100

45 min

~ 300

60 min

Hemorrhage(20-30 mmHg × 60 min)n = 5

~ 150

3 h

~ 41

<  15 min

~ 290

45 min

Namas 2009 [38]

Animal (insult): Swine (Trauma and Hemorrhage vs. Hemorrhage)

Survival: 2 h after resuscitation

Trauma (anterolateral thoractomy and pericardial window) + Hemorrhage (MAP < 30 mmHg × 10 min, MAP < 20 mmHg for 10 s, or MAP>/= 30 × 90 min). n = 4 (non-survivors)

~ 90

90 min

~ 15

90 min

~ 170

90 min

Hemorrhage (MAP < 30 mmHg × 10 min, MAP < 20 mmHg for 10 s, or MAP >/= 30 × 90 min). n = 3 (non-survivors)

~ 1

baseline

~ 20

60 min

~ 100

baseline

Trauma (anterolateral thoractomy and pericardial window) + Hemorrhage (MAP < 30 mmHg × 10 min, MAP < 20 mmHg for 10 s, or MAP>/= 30 × 90 min). n = 7 (survivors)

~ 40

90 min

~ 1

baseline

~ 240

90 min

Hemorrhage (MAP < 30 mmHg × 10 min, MAP < 20 mmHg for 10 s, or MAP >/= 30 × 90 min). n = 9 (survivors)

~ 30

baseline

5

baseline

~ 600

0 min

  1. Literature review of animal and clinical studies comparing trauma +/− sepsis +/− hemorrhagic insults
  2. ~Serum cytokine level (pg/mL) approximated from article’s figure
  3. NHP nonhuman primate, NMRC Naval Medical Research Center, PHM Polytrauma and Hemorrhage Model, THM Trauma and Hemorrhage Model, IRI Ischemia Reperfusion Injury, SMA Superior Mesenteric Artery
  4. amean cytokine value within first 6 h of injury