Prognostic value of melatonin in patients with sepsis: a comparison of survivors and nonsurvivors

Introduction

Our objective was to investigate the plasma levels of melatonin and the prognostic value of these markers in patients with sepsis. This is a prospective study of 131 patients over 22 years old with sepsis in the ICU.

Methods

The patients were divided into two groups containing 72 patients as survivors (Group I) and 59 patients as nonsurvivors (Group II). The blood collection was performed in the night (02.00 to 04.00 hours) and the Acute Physiologic and Chronic Health Evaluation II (APACHE II) score calculated on the day of hospitalisation, second day and the last day (discharge or death). The samples were centrifuged methodically and plasma samples were preserved at -200°C. After reaching the target quantity, all plasma samples were studied with RIA method at room temperature.

Results

Statistically significant high APACHE II values were determined in Group II compared with Group I on the all days (P < 0.05). Statistically significant low nocturnal plasma melatonin values were determined in Group II compared with Group I on the last day (P < 0.05). In Group II, duration of mechanical ventilation and stay of ICU are longer, and at the last days of biochemistry parameters failed (elevation of urea, creatinine, serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase) (P < 0.05).

Conclusions

We conclude that from plasma melatonin values it is impossible to predict the prognosis but during the follow-up these values can demonstrate the status of prognosis in septic patients. There are several factors affecting these melatonin values; thereby we propose that further research should be performed.