Abstract
Introduction: Resistive breathing due to airflow limitation is observed during the natural course of chronic obstructive pulmonary disease (COPD), especially during acute exacerbation of COPD (AECOPD) and is characterized by elevated cytokine plasma levels.
Objective: To test the hypothesis that the respiratory muscles and/or the mechanically stressed lung contribute to the elevated cytokine plasma levels in patients with AECOPD and that these levels would be decreased after respiratory muscles relaxation due to mechanical ventilation.
Methods: 30 patients with AECOPD, that led to endotracheal intubation and mechanical ventilation (intervention group) and 7 patients with COPD in steady state, which were intubated and mechanically ventilated for elective surgery (control group) were used.
Blood samples were collected just before, 20 minutes and 6 hours after intubation (intervention group) and just before and 20 minutes after intubation (control group).
Luminex 100 IS technique was used to access the cytokine plasma levels.
Results: IL-6, IL-8, Eotaxin and EGF plasma levels decreased statistically significantly over time, whereas IL-5, IL-8, TNF-α, INF-γ, MCP-1 and RANTES levels didn't change significantly over time (intervention group).
Plasma levels of all measured cytokines did not change significantly over time in the control group.
Conclusions: Application of mechanical ventilation in patients with AECOPD leads to decreased plasma levels for circulating IL-6, IL-10, Eotaxin and EGF. The respiratory muscles and especially the contracting diaphragm and/or the mechanically stressed "inflammatory" lung could contribute to the elevate levels of these cytokines.
- © 2014 ERS
