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Cytokines during weaning from ventilator


Authors: V. Černý;  P. Živný *;  P. Dostál;  R. Pařízková
Authors‘ workplace: Klinika anesteziologie a resuscitace, Fakultní nemocnice Hradec Králové, přednosta MUDr. Vladimír Černý, Ph. D. * Ústav klinické biochemie a diagnostiky, Fakultní nemocnice Hradec Králové, přednosta doc. MUDr. Vladimír Palička, CSc.
Published in: Anest. intenziv. Med., , 1999, č. 5, s. 217-220
Category:

Overview

Muscular fatigue as one of the symptoms of organ dysfunction can contribute to difficult weaning from ventilatory support in septic patients onlong-term ventilatory support. Pathogenesis of this muscular dysfunction is not completely understood; however, various experimental papers implythat TNF-a negatively affects diaphragm contractility and metabolism of striated muscles. In 40 patients we prospectively followed the levels of selectedcytokines (TNF-a, IL-8, sIL-2R) during mechanical ventilation and weaning period. According to the length of weaning, patients were divided intotwo groups: group S, weaning period Ł 3 days, n = 15; group L, weaning period > 3 days, n = 22. Weaning period in patients from group S was 1,7± 0,7 days; in patients from group L 9,0 ± 3,7 days. Significantly higher and persistent levels of TNFa and IL-8 were found in group L. The resultssupport the assumption that cytokines play a part in pathogenesis of muscular dysfunction in septic patients.

Key words:
sepsis – multiorgan dysfunction syndrome – muscular dysfunction – weaning from ventilator – cytokines

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Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
Topics Journals
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