The clinical significance of serum and bronchoalveolar lavage inflammatory cytokines in patients at risk for Acute Respiratory Distress Syndrome

BMC Pulmonary Medicine

Despina Kyriakou³  Nikolaos Karkavitsas¹  George Patlakas⁶  Athanasia Pataka⁶  Stavros Anevlavis⁶  Ioannis Pneumatikos⁶  Panagiotis Agouridakis⁵  Katerina M Antoniou⁴  Michael G Alexandrakis²  Demosthenes Bouros⁶ 

[1] Department of Nuclear Medicine, University General Hospital of Heraklion, Heraklion, Greece;Department of Hematology, University General Hospital of Heraklion, Heraklion, Greece;Department of Hematology, University General Hospital of Larissa, Larissa, Greece;Department of Pneumonology, University General Hospital of Heraklion, Heraklion, Greece;Intensive Care Unit, Rethymnon General Hospital, Rethymnon, Greece;Department of Pneumonology and Intensive Care Unit, University General Hospital of Alexandroupolis, Alexandroupolis, Greece

关键词: outcome;    bronchoalveolar lavage;    cytokines;    ARDS;   

Others  :  1172937
DOI  :  10.1186/1471-2466-4-6

 received in 2004-05-10, accepted in 2004-08-17,  发布年份 2004

【 摘 要 】

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.

【 授权许可】

   
2004 Bouros et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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