Background: Many patients die from sepsis and multiple organ failure, even though proper management in shock patients. Early prediction of sepsis in shock patients is important and used in various ways, such as c-reactive protein (CRP), white blood cell (WBC) and procalcitonin (PCT), but they have some problems. Recently, toll-like receptor (TLR), macrophage migration inhibitory factor (MIF) have emerged as predictive factors.

Aims: Our study aims to explore the significance of TLR, MIF as predictors of sepsis in shock patients.

Methods: This study were conducted on prospective observational study patients who visited an emergency medical center in a university hospital from March 1, 2019 to December 31, 2019 and were intended for shock patients aged 18 or older. We measured WBC, CRP, PCT, MIF, TLR₄, TNF-α, Interleukin-6 (IL-6), and lactic acid with serum taken from the patient´s blood. The definition of sepsis was defined as being part of SIRS criteria with infections within a week.

Results: 153 hemorrhagic shock patients were registered in emergency department, 44 of whom had sepsis within a week. The PCT, WBC, TNF-α, IL-6 did not differ in the comparison between sepsis and non-sepsis patients, while the CRP was somewhat high in sepsis patients (133.95±16.24mg/L > 60.46±3,57mg/L). However, MIF was significantly elevated in sepsis (2633±710pg/mL) to non-sepsis group (1460±680pg/mL). and also TLR₄ was elevated in sepsis (16.27±2.05) to non-sepsis group (7.78±0.59). There was no correlation between MIF, TLR₄ and lactic acid, which is the diagnostic criteria of shock.

Conclusions: It is believed that MIF amd TLR₄ may be used as predictors of sepsis in shock patients. However, more research on the occurrence of MIF and TLR₄ are thought to be necessary.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/significance-of-macrophage-migration-inhibitory-factor-and-toll-like-receptor-4as-predictive-factors-of-sepsis-in-shock-patients/