Evaluation of systemic inflammation in patients being weaned from mechanical ventilation

• Main Author: Forgiarini, Soraia Genebra Ibrahim
• Publication Date: 2018
• Other Authors: Rosa, Darlan Pase da, Forgiarini, Luiz Felipe, Teixeira, Cassiano, Andrade, Cristiano Feijó, Forgiarini Júnior, Luiz Alberto, Felix, Elaine Aparecida, Friedman, Gilberto
• Format: Article
• Language: eng
• Source: Repositório Institucional da UFRGS
• Download full: http://hdl.handle.net/10183/180040
• topic: Respiração artificial; Desmame do respirador; Inflamação; Fatores de risco; Mechanical ventilation; Weaning; Inflammatory factors

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)-1b, IL-6, IL-8, and IL-10, tumour necrosis factor alpha (TNFa) 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 TNFa, 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.