Aisiku Imo P, Yamal Jose-Miguel, Doshi Pratik, Benoit Julia S, Gopinath Shankar, Goodman Jerry C, Robertson Claudia S
Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Division of Biostatistics, University of Texas School of Public Health, Houston, TX, USA.
Crit Care. 2016 Sep 15;20:288. doi: 10.1186/s13054-016-1470-7.
Patients with severe traumatic brain injury (TBI) are at risk of the development of acute respiratory distress syndrome (ARDS). TBI and ARDS pathophysiologic mechanisms are known to independently involve significant inflammatory responses. The literature on the association between plasma inflammatory cytokines and ARDS in patients with TBI is sparse.
The study was a secondary analysis of the safety of a randomized trial of erythropoietin and transfusion threshold in patients with severe TBI. Inflammatory markers within the first 24 hours after injury were compared in patients who developed ARDS and patients without ARDS, using Cox proportional hazards models.
There were 200 patients enrolled in the study. The majority of plasma and cerebrospinal fluid (CSF) cytokine levels were obtained within 6 hours. Plasma proinflammatory markers IL-6 and IL-8 and anti-inflammatory marker IL-10 were associated with the development of ARDS (adjusted hazard ratio (HR) = 1.55, confidence interval (CI) = 1.14, 2.11, P = 0.005 for IL-6; adjusted HR = 1.32, CI = 1.10, 1.59, P = 0.003 for IL-8).
Plasma markers of IL-6, IL-8, and IL-10 are associated with ARDS in patients with severe TBI.
NCT00313716 registered 4/2006.
重度创伤性脑损伤（TBI）患者有发生急性呼吸窘迫综合征（ARDS）的风险。已知TBI和ARDS的病理生理机制独立涉及显著的炎症反应。关于TBI患者血浆炎症细胞因子与ARDS之间关联的文献较少。
本研究是对重度TBI患者促红细胞生成素和输血阈值随机试验安全性的二次分析。使用Cox比例风险模型，比较发生ARDS的患者和未发生ARDS的患者在受伤后24小时内的炎症标志物。
共有200名患者参与本研究。大多数血浆和脑脊液（CSF）细胞因子水平在6小时内获得。血浆促炎标志物IL-6和IL-8以及抗炎标志物IL-10与ARDS的发生相关（IL-6的调整风险比（HR）=1.55，置信区间（CI）=1.14, 2.11，P = 0.005；IL-8的调整HR = 1.32，CI = 1.10, 1.59，P = 0.003）。
IL-6、IL-8和IL-10的血浆标志物与重度TBI患者的ARDS相关。
NCT00313716于2006年4月注册。
