నైరూప్య

Initial serum level of TNF- α as an outcome predictor in pediatric patient with sepsis

Idham Jaya Ganda, Yustin Andriani, St. Aizah Lawang, Dasril Daud

Background: Sepsis is the leading causes of morbidity and mortality in critical patients in many intensive care units. TNF-α was the first circulating proinflamatory cytokine to be widely evaluated in sepsis patients. Objective: The aim of this study was to determine the role of TNF-α as an outcome predictor in pediatric sepsis patient. Methods: This prospective cohort study was conducted in Pediatric Intensive Care Unit Wahidin Sudirohusodo hospital from December 2015 until May 2016. A total of 70 sepsis patients were included. Plasma specimens were collected at admission, then the patients were being followed up if the patients develop septic shock or not. The diagnosis of sepsis is using the International Pediatric Sepsis Consensus 2005 criteria. Serum TNF-α was measured using Enzyme Linked Immunosorbent Assay technique. Results: The initial serum levels of TNF-α was significantly increased in both groups, but higher in the septic shock group. Cut off point ≥ 400pg/ml was obtained through the ROC, with the sensitivity 100%, specificity 100%, positive predictive value 100%, and negative predictive value 100%. Conclusion: The initial serum level of TNF-α can be used as a predictor outcome of sepsis patient in children and the limit of level ≥ 400 pg/ml is the most optimal cut off point as a prognostic value.