Citation

Raymondos K, Martin MU, Schmudlach T, Baus S, Weilbach C, Welte T, Krettek C, Frink M, Hildebrand F. Injury 2012; 43(2): 189-195.

Affiliation

Department of Anaesthesiology, Medical School Hannover, Germany.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.injury.2011.05.034

PMID

21703617

Abstract

Alveolar IL-8 has been reported to early identify patients at-risk to develop ARDS. However, it remains unknown how alveolar IL-8 is related to pulmonary and systemic inflammation in patients predisposed for ARDS. We studied 24 patients 2-6h after multiple trauma. Patients with IL-8 >200pg/ml in bronchoalveolar lavage (BAL) were assigned to the group at high risk for ARDS (H, n=8) and patients with BAL IL-8 <200pg/ml to the group at low risk for ARDS (L, n=16). ARDS developed within 24h after trauma in 5 patients at high and at least after 1 week in 2 patients at low risk for ARDS (p=0.003). High-risk patients had also increased BAL IL-6, TNF-α, IL-1β, IL-10 and IL-1ra levels (p<0.05). BAL neutrophil counts did not differ between patient groups (H vs. L, 12% (3-73%) vs. 6% (2-32%), p=0.1) but correlated significantly with BAL IL-8, IL-6 and IL-1ra. High-risk patients had increased plasma levels of pro- but not anti-inflammatory mediators. The enhanced alveolar and systemic inflammation associated with alveolar IL-8 release should be considered to identify high-risk patients for pulmonary complications after multiple trauma to adjust surgical and other treatment strategies to the individual risk profile.

Language: en