Evaluation of systemic inflammation in patients being weaned from mechanical ventilation

• Main Authors: Soraia Genebra Ibrahim Forgiarini, Darlan Pase da Rosa, Luiz Felipe Forgiarini, Cassiano Teixeira, Cristiano Feijó Andrade, Luiz Alberto Forgiarini Junior, Elaine Aparecida Felix, Gilberto Friedman
• Format: Article
• Language: English
• Published: Faculdade de Medicina / USP 2018-06-01
• Series: Clinics
• Subjects: Mechanical Ventilation; Weaning; Inflammatory Factors
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322018000100233&lng=en&tlng=en

OBJECTIVES: The aim of this study was to evaluate systemic inflammatory factors and their relation to success or failure in a spontaneous ventilation test. METHODS: This cross-sectional study included a sample of 54 adult patients. Demographic data and clinical parameters were collected, and blood samples were collected in the first minute of the spontaneous ventilation test to evaluate interleukin (IL)-1β, IL-6, IL-8, and IL-10, tumour necrosis factor alpha (TNFα) and C-reactive protein. RESULTS: Patients who experienced extubation failure presented a lower rapid shallow breathing index than those who passed, and these patients also showed a significant increase in C-reactive protein 48 hours after extubation. We observed, moreover, that each unit increase in inflammatory factors led to a higher risk of spontaneous ventilation test failure, with a risk of 2.27 (1.001 - 4.60, p=0.049) for TNFα, 2.23 (1.06 - 6.54, p=0.037) for IL-6, 2.66 (1.06 - 6.70, p=0.037) for IL-8 and 2.08 (1.01 - 4.31, p=0.04) for IL-10, and the rapid shallow breathing index was correlated with IL-1 (r=-0.51, p=0.04). CONCLUSIONS: C-reactive protein is increased in patients who fail the spontaneous ventilation test, and increased ILs are associated with a greater prevalence of failure in this process; the rapid shallow breathing index may not be effective in patients who present systemic inflammation.