Department of Pediatrics, Universidade Federal do Rio Grande do Sul, and Newborn Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
J Pediatr. 2010 Jan;156(1):16-9. doi: 10.1016/j.jpeds.2009.07.027.
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.
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.
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.
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.
评估新生儿在机械通气前和通气后 2 小时内的白细胞介素（IL）-1β、IL-6、IL-8、IL-10 和肿瘤坏死因子（TNF）-α的血浆水平。
前瞻性研究无机械通气和/或通气支持史的足月和晚期早产儿。排除标准为先天性畸形、先天性感染、一氧化氮的使用、正压通气复苏以及分娩室或新生儿重症监护病房中导致气管插管的任何操作。在插管和机械通气前以及 2 小时后采集血液样本以检测 IL-1β、IL-6、IL-8、IL-10 和 TNF-α水平。
共纳入 19 名胎龄为 35.8±1.9 周、出生体重为 2280±370 g 的新生儿。促炎细胞因子增加：IL-8（2.5 倍）、IL-1β（7.5 倍）和 TNF-α（10 倍），抗炎细胞因子 IL-10 下降 90%。尽管通气前后的 IL-6 中位数相似，但在 89.4%的婴儿中 IL-6 增加。
机械通气的短时间会导致促炎和抗炎细胞因子的血浆水平失衡。细胞因子对机械通气的全身反应可能导致呼吸机诱导的肺损伤。
