PT  - JOURNAL ARTICLE
AU  - J. Sellares
AU  - H. Loureiro
AU  - M. Ferrer
AU  - R. Amaro
AU  - R. Farré
AU  - A. Torres
TI  - The effect of spontaneous breathing on systemic interleukin-6 during ventilator weaning
AID  - 10.1183/09031936.00037511
DP  - 2011 Jan 01
TA  - European Respiratory Journal
PG  - erj00375-2011
4099  - http://erj.ersjournals.com/content/early/2011/07/12/09031936.00037511.short
4100  - http://erj.ersjournals.com/content/early/2011/07/12/09031936.00037511.full
AB  - During the weaning process, spontaneous breathing trial (SBT) involves cardiopulmonary stress for ventilated patients. As interleukin [IL]-6 is a major modulator of the stress response, we hypothesized that systemic IL-6 increases during the SBT and that this increase is more evident in SBT failure.Forty-nine SBTs of 30-minute duration were performed on different mechanically-ventilated patients, classified as SBT failure or success. Blood samples were drawn before and at the end of the SBT. An additional sample was drawn 24 hours later in a subset of patients (n=39). Serum IL-6 levels and other inflammatory mediators commonly associated with stress were determined.IL-6 levels increased from mechanical ventilation to spontaneous breathing in all patients (p=0.02) and in COPD population (p=0.05) with SBT failure compared to success, but not in non-COPD patients (p=0.12). After 24 hours of SBT stress, IL-6 levels decreased in patients with SBT failure (under MV at that point) (p=0.02) and those with weaning success (p=0.04). No changes were observed in the remaining inflammatory mediators.Systemic IL-6 increases during a 30-minute failed SBT, especially in COPD patients. Future studies may corroborate the different IL-6 responses among different populations who initiate weaning, together with the potential clinical implications.