Cytokines during weaning from ventilator

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