The Clinical Significance of Serum and Bronchoalveolar Lavage Inflammatory Cytokines in Patients at Risk for Acute Respiratory Distress Syndrome

Overview

Journal BMC Pulm Med

Publisher Biomed Central

Specialty Pulmonary Medicine

Date 2004 Aug 19

PMID 15315713

Citations 39

Authors

Demosthenes Bouros

Michael G Alexandrakis

Katerina M Antoniou

Panagiotis Agouridakis

Ioannis Pneumatikos

Stavros Anevlavis

Athanasia Pataka

George Patlakas

Nikolaos Karkavitsas

Despina Kyriakou

Affiliations

Soon will be listed here.

Abstract

Background: The predictive role of many cytokines has not been well defined in Acute Respiratory Distress Syndrome (ARDS).

Methods: We measured prospectively IL-4, IL-6, IL-6 receptor, IL-8, and IL-10, in the serum and bronchoalveolar lavage fluid (BALF) in 59 patients who were admitted to ICU in order to identify predictive factors for the course and outcome of ARDS. The patients were divided into three groups: those fulfilling the criteria for ARDS (n = 20, group A), those at risk for ARDS and developed ARDS within 48 hours (n = 12, group B), and those at risk for ARDS but never developed ARDS (n = 27, group C).

Results: An excellent negative predictive value for ARDS development was found for IL-6 in BALF and serum (100% and 95%, respectively). IL-8 in BALF and IL-8 and IL-10 serum levels were higher in non-survivors in all studied groups, and were associated with a high negative predictive value. A significant correlation was found between IL-8 and APACHE score (r = 0.60, p < 0.0001). Similarly, IL-6 and IL-6r were highly correlated with PaO2/FiO2 (r = -0.27, p < 0.05 and r = -0.55, p < 0.0001, respectively).

Conclusions: BALF and serum levels of the studied cytokines on admission may provide valuable information for ARDS development in patients at risk, and outcome in patients either in ARDS or in at risk for ARDS.

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