Puyo Carlos A, Dahms Thomas E
Department of Anesthesia and Critical Care, Washington University, St Louis, MO 63110, USA.
Arch Otolaryngol Head Neck Surg. 2012 Sep;138(9):854-8. doi: 10.1001/archoto.2012.1746.
To investigate the inflammatory markers associated with short-term endotracheal intubation in healthy surgical patients.
An observational and prospective study of subjects scheduled for same-day surgery procedures.
Level I trauma center.
Fourteen healthy patients intubated for same-day surgery procedures. The median duration of surgery was 3 hours.
Serial lavages above the tracheal cuff were obtained at the beginning of surgery, at 1 hour, and at the end of surgery; samples were assayed for cellular counts and levels of cytokines and complement 5a (C5a).
The total number of polymorphonuclear cells (PMNs) increased almost 10-fold from intubation to extubation (P < .01). The levels of 3 of the cytokines measured in tracheal lavage supernatants were significantly elevated over the time of intubation: tumor necrosis factor (TNF) (P < .01), interleukin 6 (IL-6) (P < .01), and IL-1β (P < .025). Levels of IL-8 showed an upward trend over time but were not significantly increased; C5a levels were significantly elevated over time (P < .05).
Short-term intubation in healthy patients resulted in significant tracheal inflammation. Involvement of the innate immune system as documented in the present study provides information that may help to better understand the pathophysiologic characteristics of subglottic stenosis and other endotracheal injuries secondary to endotracheal intubation.
研究健康外科手术患者短期气管插管相关的炎症标志物。
对计划进行当日手术的受试者进行观察性前瞻性研究。
一级创伤中心。
14名因当日手术进行气管插管的健康患者。手术中位时长为3小时。
在手术开始时、1小时及手术结束时获取气管插管套囊上方的系列灌洗样本；对样本进行细胞计数以及细胞因子和补体5a（C5a）水平检测。
从插管到拔管，多形核细胞（PMN）总数增加近10倍（P <.01）。气管灌洗上清液中检测的3种细胞因子水平在插管期间显著升高：肿瘤坏死因子（TNF）（P <.01）、白细胞介素6（IL-6）（P <.01）和IL-1β（P <.025）。IL-8水平随时间呈上升趋势但未显著升高；C5a水平随时间显著升高（P <.05）。
健康患者的短期插管导致显著的气管炎症。本研究记录的先天性免疫系统参与情况提供了有助于更好理解声门下狭窄及气管插管继发的其他气管损伤病理生理特征的信息。
