Comparison of airway pressure release ventilation and low tidal volume ventilation in the degree of IL-6 in patients with ARDS

Abstract

Objective To compare the effects of airway pressure release ventilation (APRV) and low tidal volume mechanical ventilation (LTV) on ventilator-associated lung injury in acute respiratory distress syndrome (ARDS) patients by measuring the plasma and alveolar lavage fluid interleukin-6 (IL-6) levels. Methods It is a randomized crossover study.Patients meet ARDS criteria were divided into 2 groups randomly.LTV group were treated with APRV first, 12 hours later switched to LTV, APRV group were treated with LTV first, 12 hours later switched to APRV.The plasma IL-6 levels at 0, 1, 12, 13 and 24h and the IL-6 levels in 0, 12 and 24h alveolar lavage fluid were compared. Results 12 hours after APRV convert to LTV, the IL-6 in serum rise from (54.92±42.44) ng/L to (69.74±41.11) ng/L(t=2.32, P=0.01); the IL-6 in alveolar lavage fluid rise from (71.17±56.47) ng/L to (91.25±46.56) ng/L (P>0.05).12 hours after LTV convert to APRV, the IL-6 in serum declined from (72.56±37.59) ng/L to (60.92±44.06) ng/L (P>0.05); the IL-6 in alveolar lavage fluid rise from (123.63±41.64) ng/L to (107.41±17.20) ng/L(P>0.05). The difference of IL-6 concentration before and after 12 h in the two groups (the difference between 24 h and 12 h vs the difference between 12 h and 0 h) was statistically significant (t=1.34, P=0.03). Conclusions APRV alleviates IL-6 level in serum of ARDS compared with the LTV. Key words: Ventilator-induced lung injury; Interleukin-6; Respiratory distress syndrome, adult; Airway pressure release ventilation