Mechanical ventilation of newborns infant changes in plasma pro- and anti-inflammatory cytokines.
OBJECTIVE
To evaluate plasma levels of interleukin (IL)-1beta, IL-6, IL-8, IL-10, and tumor necrosis factor (TNF)-alpha in newborn infants immediately before and after 2 hours of mechanical ventilation.


METHODS
Term and late preterm neonates with no history of mechanical ventilation and/or ventilatory support were studied prospectively. Exclusion criteria were congenital malformations, congenital infections, use of nitric oxide, resuscitation with positive-pressure ventilation, and any procedure in the delivery room or neonatal intensive care unit that resulted in tracheal intubation. Blood samples for IL-1beta, IL-6, IL-8, IL-10, and TNF-alpha levels were collected before intubation and mechanical ventilation and 2 hours later.


RESULTS
Nineteen newborn infants with gestational age 35.8 +/- 1.9 weeks and birth weight 2280 +/- 370 g were included. Pro-inflammatory cytokines increased: IL-8 (2.5-fold), IL-1beta (7.5-fold), and TNF-alpha (10-fold), and the anti-inflammatory cytokine IL-10 decreased by 90%. Although median IL-6 levels were similar between before and after ventilation, IL-6 increased in 89.4% of infants.


CONCLUSIONS
A short period of mechanical ventilation promotes an imbalance of plasma levels of pro-inflammatory and anti-inflammatory cytokines. The systemic alteration of cytokines in response to mechanical ventilation may lead to ventilator-induced lung injury.
Department of Pediatrics, Universidade Federal do Rio Grande do Sul, and Newborn Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
Betania
B
Bohrer
Rita C
RC
Silveira
Eurico C
EC
Neto
Renato S
RS
Procianoy
D006801:Humans; D007231:Infant, Newborn; D016753:Interleukin-10 / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007378:Interleukins / Q000097:blood*; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D055397:Ventilator-Induced Lung Injury / Q000097:blood
D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D010100:Oxygen