The declined levels of inflammatory cytokines related with weaning rate during period of septic patients using ventilators.

INTRODUCTION: Approximately 50% of patients with sepsis-induced acute lung injury and acute respiratory distress syndrome require mechanical ventilation. Patients with extended mechanical ventilator use routinely develop reinfections, which increases hospital stay, mortality, and health care cost. Some studies have pointed out inflammatory factors concentrations can affect ventilator weaning, but do not indicate changed inflammatory factors related to ventilator weaning during using ventilators.

OBJECTIVES: This study aimed to investigate during period of septic patients using ventilators, the inflammatory cytokines concentrations related with weaning rate.

METHODS: Blood was collected from 35 septic patients before and during ventilator use on days 1, 7, 14, and 21 (or weaning).

RESULTS: 58.3% (N = 20) of septic patients with mechanical ventilators were weaned successfully within 21 days (ventilator weaned group, VW), 16.7% (N = 6) did not wean within 21 days (ventilator dependent group, VD), and 25% died (death group) in hospital. Before ventilator use, higher C-reactive protein (CRP), IL-6, and IL-8 levels were measured in the death group than in all other groups (P < .05). During ventilator use, CRP, IL-6, and IL-8 concentrations declined significantly in VW and VD patients (P < .05). In addition, IL-6 concentrations in the VW group were significantly lower than in the VD group at 14 and 21 days (P < .05).

CONCLUSION: The factors of ventilators weaning successfully such as disease control, nutritional status, and so on. The declined levels of serum inflammatory cytokines, especially IL-6, improved inflammation status might be one factor of successfully weaning during septic patients on ventilators.