BODY WATER CONTENT IS AN INDEX OF INFLAMMATION IN CRITICALLY ILL PATIENTS Katarzyna Czarko-Wicha 1, Przemyslaw Zadora 1, Ziemowit Rzecki 1, Edyta Kotlinska-Hasiec 1, Wojciech Zaluska 2, Wojciech Dabrowski 1, Manu LNG Malbrain 3 1.Department of Anaesthesiology and Intensive Therapy Medical University of Lublin, POLAND, 2.Department of Nephrology Medical University of Lublin, POLAND, 3.Intensive Care Unit and High Care Burn Unit, Ziekenhuis Netwek Antwerpen, ZNA Campus Stuivenberg/St-Erasmus, Antwerp, BELGIUM

Introduction  Inflammation: cardinal signs: dolor (pain), calor (heat), rubor (redness), functio laesa (loss of function) and TUMOUR (SWELLING) mediators of inflammation: leukotrienes, chemokines, prostaglandins interleukines (IL): IL-1ß, IL-6, IL-8, IL-17α, Tumour Necrosis Factor α (TNFα), C-reactive protein (CRP)  Systemic inflammatory response - fluid extravasation  Procalcitonin (PCT)  Hypothesis: inflammation affects body water content

The purpose of the present study was to compare the severity of inflammation measured by plasma cytokine, procalcitonin and CRP-protein concentrations with body water content in septic or septic shock patients admitted into intensive care unit (ICU).

Methods:  Adult patients were studied.  Plasma TNFα, IL-1β, IL-6, IL-17α, PCT and CRP concentrations were measured immediately after patients’ admission.  Body water content was assessed by volume excess (VE), total body water (TBW) and extracellular body water (ECW). Whole body bioimpedance was used for VE, TBW and ECW measurement.  Based on clinical outcomes, the data were analysed for patients, who survived 28 days (survivors) compared to those who died during 28 days of treatment (non-survivors).

Results:  40 patients (16 female and 24 male) aged 24 – 73 were enrolled.  The 28 day mortality was 32.5% (13 patients).  PCT and CRP were significantly higher in non-survivors than survivors (PCT ng/mL [0.48; 28.2] vs 0.75 ng/mL [0.27; 38.9] CRP – 241 mg% [39.1; 320.9] vs mg% [1.9; 335.2])

Results:

TNFαIL-1βIL-6IL-17αPCTCRP STUDIED POPULATION VENS TBW p < 0.01, r = 0.46 NS p < 0.001, r = 0.51 NS p < 0.001, r = 0.56 NS ECW p < 0.01, r = 0.5 NS p < 0.01, r = 0.49 NS p < 0.01, r = 0.46 NS SURVIVORS VENS p < 0.01, r = 0.56 NS TBW p < 0.05, r = 0.46 NS p < 0.001, r = 0.7 p < 0.01, r = 0.6 p < 0.001, r = 0.75 p < 0.01, r = 0.49 ECW p < 0.05, r = 0.47 NS p < 0.01, r = 0.53 p < 0.01, r = 0.56 p < 0.001, r = 0.63 p < 0.05, r = 0.43 NON- SURVIVORS VE p < 0.05, r = 0.65 NS TBWNS ECW p < 0.05, r = 0.58 NS

Conclusions: 1/ ECW is an index of severity in inflammation in critically ill patients, 2/ TBW is an index of inflammation only in survivors,

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