Systemic Cytokine Response predicts the Outcome of Patients from Mechanical Ventilation

Abstract

ABSTRACT Purpose Despite the lifesaving potential, mechanical ventilation (MV) imposes a considerable amount of mechanical stress on the lung. Pulmonary and systemic cytokine release due to inflammatory process triggered by MV may give valuable information on patient outcome. Materials and methods Thirty patients aged >18 years with acute respiratory distress who required MV were enrolled for the study. Three milliliters of the venous blood was collected immediately after the initiation of MV and at 24 hours. Serum levels of interleukin (IL)-6, IL-8 and, tumor necrosis factor-α (TNF-α) were estimated using quantitative immunometric sandwich enzyme immunoassay technique. Based on their outcome from MV, they were divided into two groups: Survivors (group I) and nonsurvivors (group II). Results Serum levels of IL-6 and IL-8 significantly increased in group II (n=13) when compared with group I (n = 17) (p < 0.0001 and p < 0.001 respectively) at 24 hours of MV. However, TNF-α did not show any significant difference between the two groups. The IL-6 >111.9 pg/mL at 24 hours of MV increases the probability of mortality by factor 2.40. An increase of IL-6 by 1 pg/mL significantly increases the relative probability of mortality by a factor of 1.004 (95% CI, 1.0003–1.0078, p = 0.0001). Conclusion Estimating the levels of IL-6 and IL-8 at 24 hours of connecting the patient to MV will help in predicting the outcome of the patient. How to cite this article Prashant A, Vishwanath P, Kotekar N, Nataraj SM, Kuruvilla C, Nagalakshmi CS, Doddamani P. Systemic Cytokine Response predicts the Outcome of Patients from Mechanical Ventilation. Indian J Med Biochem 2017;21(1):5-10.