Anest. intenziv. Med. 1999;10(5):217-220
Cytokines during weaning from ventilatorArticles
- Klinika anesteziologie a resuscitace, Fakultní nemocnice Hradec Králové, přednosta MUDr. Vladimír Černý, Ph. D.
- 1 Ústav klinické biochemie a diagnostiky, Fakultní nemocnice Hradec Králové, přednosta doc. MUDr. Vladimír Palička, CSc.
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.
Keywords: sepsis; multiorgan dysfunction syndrome; muscular dysfunction; weaning from ventilator; cytokines
Published: October 1, 1999 Show citation