Mechanical Ventilation of Newborns Infant Changes in Plasma Pro- and Anti-Inflammatory Cytokines

ObjectiveTo evaluate plasma levels of interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor (TNF)-α in newborn infants immediately before and after 2 hours of mechanical ventilation.Study designTerm and late preterm neonates with no history of mechanical ventilation and/or ventilatory support were studied prospectively. Exclusion criteria were congenital malformations, congenital infections, use of nitric oxide, resuscitation with positive-pressure ventilation, and any procedure in the delivery room or neonatal intensive care unit that resulted in tracheal intubation. Blood samples for IL-1β, IL-6, IL-8, IL-10, and TNF-α levels were collected before intubation and mechanical ventilation and 2 hours later.ResultsNineteen newborn infants with gestational age 35.8 ± 1.9 weeks and birth weight 2280 ± 370 g were included. Pro-inflammatory cytokines increased: IL-8 (2.5-fold), IL-1β (7.5-fold), and TNF-α (10-fold), and the anti-inflammatory cytokine IL-10 decreased by 90%. Although median IL-6 levels were similar between before and after ventilation, IL-6 increased in 89.4% of infants.ConclusionsA short period of mechanical ventilation promotes an imbalance of plasma levels of pro-inflammatory and anti-inflammatory cytokines. The systemic alteration of cytokines in response to mechanical ventilation may lead to ventilator-induced lung injury.