title: Plasma cytokine levels fall in preterm newborn infants on nasal CPAP with early respiratory distress.
abstract: BACKGROUND
  Early nCPAP seems to prevent ventilator-induced lung injury in humans, although the pathophysiological mechanisms underlying this beneficial effect have not been clarified yet.
  
  
  OBJECTIVE
  To evaluate plasma levels IL-1β, IL-6, IL-8, IL-10, and TNF-α immediately before the start of nCPAP and 2 hours later in preterm infants.
  
  
  METHODS
  Prospective cohort including preterm infants with 28 to 35 weeks gestational age with moderate respiratory distress requiring nCPAP. Extreme preemies, newborns with malformations, congenital infections, sepsis, surfactant treatment, and receiving ventilatory support in the delivery room were excluded. Blood samples were collected right before and 2 hours after the start of nCPAP.
  
  
  RESULTS
  23 preterm infants (birth weight 1851±403 grams; GA 32.3±1.7 weeks) were treated with nCPAP. IL-1β, IL-10, TNF-α levels were similar, IL-8 levels were reduced in 18/23 preterm infants and a significant decrease in IL-6 levels was observed after 2 hours of nCPAP. All newborns whose mothers received antenatal steroids had lower cytokine levels at the onset of nCPAP than those whose mothers didn't receive it; this effect was not sustained after 2 hours of nCPAP.
  
  
  CONCLUSIONS
  Early use nCPAP is not associated with rising of plasma pro-inflammatory cytokines and it seems to be a less harmful respiratory strategy for preterm with moderate respiratory distress.
authors: Department of Pediatrics, Universidade Federal do Rio Grande do Sul, and Newborn Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Clarissa Gutierrez
authors: CG
authors: Carvalho
authors: Department of Pediatrics, Universidade Federal do Rio Grande do Sul, and Newborn Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Rita de Cassia
authors: Rde C
authors: Silveira
authors: Department of Pediatrics, Universidade Federal do Rio Grande do Sul, and Newborn Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Eurico Camargo
authors: EC
authors: Neto
authors: Department of Pediatrics, Universidade Federal do Rio Grande do Sul, and Newborn Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Renato Soibelmann
authors: RS
authors: Procianoy
mesh_terms: D045422:Continuous Positive Airway Pressure; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007363:Intensive Care Units, Neonatal; D008297:Male; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000097:blood* / Q000628:therapy*; D013256:Steroids / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D016207:Cytokines; D013256:Steroids