TY  - JOUR
PY  - 2012//
TI  - Early alveolar and systemic mediator release in patients at different risks for ARDS after multiple trauma
JO  - Injury
A1  - Raymondos, Konstantinos
A1  - Martin, Michael U.
A1  - Schmudlach, Tanja
A1  - Baus, Stefan
A1  - Weilbach, Christian
A1  - Welte, Tobias
A1  - Krettek, Christian
A1  - Frink, Michael
A1  - Hildebrand, Frank
SP  - 189
EP  - 195
VL  - 43
IS  - 2
N2  - Alveolar IL-8 has been reported to early identify patients at-risk to develop ARDS. However, it remains unknown how alveolar IL-8 is related to pulmonary and systemic inflammation in patients predisposed for ARDS. We studied 24 patients 2-6h after multiple trauma. Patients with IL-8 >200pg/ml in bronchoalveolar lavage (BAL) were assigned to the group at high risk for ARDS (H, n=8) and patients with BAL IL-8 <200pg/ml to the group at low risk for ARDS (L, n=16). ARDS developed within 24h after trauma in 5 patients at high and at least after 1 week in 2 patients at low risk for ARDS (p=0.003). High-risk patients had also increased BAL IL-6, TNF-α, IL-1β, IL-10 and IL-1ra levels (p<0.05). BAL neutrophil counts did not differ between patient groups (H vs. L, 12% (3-73%) vs. 6% (2-32%), p=0.1) but correlated significantly with BAL IL-8, IL-6 and IL-1ra. High-risk patients had increased plasma levels of pro- but not anti-inflammatory mediators. The enhanced alveolar and systemic inflammation associated with alveolar IL-8 release should be considered to identify high-risk patients for pulmonary complications after multiple trauma to adjust surgical and other treatment strategies to the individual risk profile.<p />  <p>Language: en</p>
LA  - en
SN  - 0020-1383
UR  - http://dx.doi.org/10.1016/j.injury.2011.05.034
ID  - ref1
ER  -