- Meeting abstract
- Open Access
Cytokine plasma levels during weaning in critically ill patients with sepsis
- Published: 16 March 2000
Keywords
- Ventilatory Support
- Spontaneous Ventilation
- Cytokine Plasma
- Institutional Approval
- Cytokine Plasma Level
Introduction
Poor muscle functions play a pivotal role in developing ventilator dependency after long term ventilatory support and studies have shown that sepsis may be associated with decreased muscle contractility. The aim of the study was to evaluate plasma levels of TNF alpha, IL-8 and sIL-2R during ventilatory support and weaning.
Methods
After institutional approval 40 critically ill patients were prospectively studied during ventilatory support and weaning, three patients due to death were excluded. All patients were weaned according to standard weaning protocol. Blood samples were drawn daily and collected until analysis. Apache II score, organ failure score (Goris), sepis organ failure assessment score (SOFA), ventilatory days and `weaning' days were recorded. After successful weaning patients were divided in two groups according to the length of weaning (W): group S (W ≤ 3 days, n = 15), group L (W >3 days, n = 22). TNFα, IL-8 and sIL-2R serum levels were selected and measured at the time of admission (T1), on the last day of full ventilatory support (T2), on the day when weaning was started (T3) and on the first day of spontaneous ventilation (T4). Values are expressed as a mean ± SD (or median and 25th and 75th percentiles), t-test or Mann Whitney Rank Sum test were used for statistical analysis (SigmaStat, Jandel Co., USA), P < 0.05 was considered statistically significant.
Results
Total ventilatory and weaning days were 9.6 ± 4.8 resp. 1.7 ± 0.7 in group S and 24.6 ± 11.3 resp. 9.0 ± 3.7 in group L. Selected results (TNFα and IL-8 in pg/ml) are presented in the Table:
Discussion
Table
T1 | T2 | T3 | T4 | |
---|---|---|---|---|
Group S - TNFα | 11.6 (5.6) | 7.72 (7.7) | 4.39 (6.1) | 0 |
Group L-TNFα | 10.1 (8) | 10.8 (5.8) | 6.7 (6.0) | 6.8 (6.0)* |
Group S - IL-8 | 63.7 (38-81) | 35.9 (0-66) | 0 (0-30) | 0 (0-0) |
Group L - IL-8 | 45.7 (34-67) | 62.7 (42-102)** | 42.7 (26-56)*** | 30.5 (0-43)§ |
Declarations
Acknowledgement
Supported by grant IGA MZ CR 3674-3