Introduction: Monitoring the inflammatory response after thermal injury is one of the major challenges in burn care. Burn injury leads to an increased inflammatory response. Markers such as CRP and IL-6 are not sensitive to predict sepsis and major infections post burn. IL-8 is one of the major mediators of the inflammatory response. IL-8 is also considered as a mediator of the inflammatory response and in metabolic processes. The aim of our study was to investigate the role of IL-8 as a diagnostic marker for infections post burn.

Methods: four hundred sixty eight pediatric patients were enrolled in this study. Plasma cytokines, acute phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days post admission. Demographics and outcome variables (length of stay, sepsis, multi organ failure, and mortality) were recorded. A cut off level for IL-8 was determined using receiver operating characteristic (ROC) analysis. Statistical analysis was evaluated by Student’s t-test corrected with Bonferroni`s post-hoc test and Chi Square test. Statistical significance is set at (p<0.05).

Results: ROC analysis identified a cut off level of 234 pg/mg for IL-8 and survival (A=0.88). Patients were grouped according this cut off in high (h) and a low (l) groups. Analysis of cytokines, and acute phase response showed significant higher levels in the h group (IL-6, CRP) (p<0.05). In the l group regression analysis revealed a significant predictive value of IL-8 to TBSA burn size and incidence of MOF (p<0.001) but not to incidence of sepsis (p=0.41). In the h group a significant link between IL-8 and sepsis (p=0.002) was identified whereas burn size and MOF were not significant related.

Conclusion: IL-8 expression is associated with burn size and infections. Levels up to 234 pg/ml are significantly related to TBSA burn size and multi organ failure. Levels greater than 234 pg/ml are correlate strongly with the incidence of sepsis and mortality. These data suggest that plasma levels of IL-8 may be a valid parameter monitoring sepsis in burn victims.