Hyperglycemia at admission to the intensive care unit is associated with elevated serum concentrations of interleukin-6 and reduced ex vivo secretion of tumor necrosis factor-α*

Wasmuth, Hermann E.; Kunz, Dagmar; Graf, Jürgen; Stanzel, S.; Purucker, Edmund; Koch, Alexander; Gartung, Carsten; Heintz, Bernhard; Gressner, A. M.; Matern, Siegfried; Lammert, Frank

doi:10.1097/01.ccm.0000124873.05080.78

Cited by 63 publications

(36 citation statements)

References 39 publications

(41 reference statements)

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“…Increases in serum IL-6 and catecholamine concentration have been reported to be associated with insulin resistance and glycogenolysis in the liver [23][24], thus promoting diabetes mellitus. Our patient also showed elevated plasma and urine cortisol levels, which also have been caused by overproduction of IL-6.…”

Section: Discussionmentioning

confidence: 99%

Systemic Inflammatory Syndrome and Hepatic Inflammatory Cell Infiltration Caused by an Interleukin-6 Producing Pheochromocytoma

et al. 2005

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Abstract. Pheochromocytoma is a tumor that produces a variety of biologically active substances in addition to catecholamines. We report here a patient with a pheochromocytoma, who presented with acute inflammatory symptoms and marked abnormalities in liver function and hematological tests. A 31-year-old man, who had experienced intermittent fever, chills and weight 1oss during the previous several months, was referred to our hospital for further evaluation. Laboratory examination revealed anemia, leukocytosis with elevated inflammatory markers, and abnormalities in coagulation and liver function tests. Histological examination revealed a marked plasmacytosis in the bone marrow and lymphocyte infiltration into the portal area of the liver. Along with increases in serum catecholamine and urine catecholamine metabolites, his serum interleukin (IL)-6 level was increased to 300 pg/ml, compared with a normal range of 3-12 pg/ml. Left adrenalectomy was performed. The adrenal tumor was densely immunostained with antibody to IL-6. After resection of his adrenal tumor, his serum IL-6 level returned to normal (11 pg/ml) and all symptoms subsided with normalization of laboratory findings.

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Section: Discussionmentioning

confidence: 99%

Systemic Inflammatory Syndrome and Hepatic Inflammatory Cell Infiltration Caused by an Interleukin-6 Producing Pheochromocytoma

et al. 2005

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“…IL-6 is secreted by macrophages, lymphocytes and other cells [10]. It has been previously reported that hyperglycaemia increases serum concentrations of IL-6 [11,12] possibly through augmented production in monocytes [11,13]. Thus patients with diabetes have elevated blood levels of IL-6, which, together with TNF-α are known to increase inflammation and the development of vascular disease and atherosclerosis, possibly by increasing oxidative stress [12,14,15,16].…”

Section: Methodsmentioning

confidence: 99%

Cytokine response to diabetic ketoacidosis (DKA) in children with type 1 diabetes (T1DM)

et al. 2011

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“…Hyperglycemia is a common consequence of critical illness and has a direct correlation with IL-6 levels. 32 Activity can decrease insulin resistance and increase muscle utilization of glucose. 4,32 Possibly, repeated sessions of passive exercise not only decrease blood glucose levels and insulin requirements in critically ill patients but also decrease IL-6 levels.…”

Section: Implications For Practice and Researchmentioning

confidence: 99%

“…32 Activity can decrease insulin resistance and increase muscle utilization of glucose. 4,32 Possibly, repeated sessions of passive exercise not only decrease blood glucose levels and insulin requirements in critically ill patients but also decrease IL-6 levels. The relationship between mobilization, IL-6 levels, blood glucose levels, and insulin requirements in critically ill patients should be explored further.…”

Section: Implications For Practice and Researchmentioning

confidence: 99%

Physiological Responses to Passive Exercise in Adults Receiving Mechanical Ventilation

Amidei

Sole

2013

American Journal of Critical Care

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A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Identify the impact of mobilization on patient outcomes. 2. Discuss the undesirable outcomes when patients are not mobilized. 3. Analyze the effect of mobilization on pain. Objective To assess physiological responses to an early standardized passive exercise protocol to prevent muscle weakness in adults receiving mechanical ventilation. Methods A quasi-experimental within-subjects repeatedmeasures design was used. Within 72 hours of intubation, 30 patients had 20 minutes of bilateral passive leg movement delivered by continuous-passive-motion machines at a standardized rate and flexion-extension. Heart rate, mean blood pressure, oxygen saturation, and cytokine levels were measured before, during, and after the intervention. The Behavioral Pain Scale was used to measure patients' comfort. Repeatedmeasures analysis of variance was used to analyze the effect of the exercise on independent variables. Results Patients were mostly white men with a mean age of 56.5 years (SD, 16.9) with moderate mortality risk and illness severity. Heart rate, mean blood pressure, and oxygen saturation did not differ from baseline at any time measured. Pain scores were significantly reduced (F 2.43,70.42 = 4.08; P = .02) 5 and 10 minutes after exercise started and remained reduced at the end of exercise and 1 hour later. Interleukin 6 levels were significantly reduced (F 1.60,43.1 = 4.35; P = .03) at the end of exercise but not after the final rest period. Interleukin 10 levels did not differ significantly. Ratios of interleukin 6 to interleukin 10 decreased significantly (F 1.61,43.38 = 3.42; P = .05) at the end of exercise and again after 60 minutes' rest. Conclusion The exercise was well tolerated, and comfort improved during and after the intervention. Cytokine levels provided physiological rationale for benefits of early exercise.

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Hyperglycemia at admission to the intensive care unit is associated with elevated serum concentrations of interleukin-6 and reduced ex vivo secretion of tumor necrosis factor-α*

Cited by 63 publications

References 39 publications

Systemic Inflammatory Syndrome and Hepatic Inflammatory Cell Infiltration Caused by an Interleukin-6 Producing Pheochromocytoma

Systemic Inflammatory Syndrome and Hepatic Inflammatory Cell Infiltration Caused by an Interleukin-6 Producing Pheochromocytoma

Cytokine response to diabetic ketoacidosis (DKA) in children with type 1 diabetes (T1DM)

Physiological Responses to Passive Exercise in Adults Receiving Mechanical Ventilation

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