Early alveolar and systemic mediator release in patients at different risks for ARDS after multiple trauma

Leukotriene B4 indicates lung injury and on-going inflammatory changes after severe trauma in a porcine long-term model

“…This complex immune response to trauma is characterized by the release of several inflammatory mediators including IL-8, IL-1β, IL-10 and IL-18 but also neutrophil migration into the lung [13,[48][49][50][51][52][53]. Persistent accumulation of neutrophils in the lung has been linked to pulmonary damage and poor survival via an interstitial inflammation, increase of interstitial space and limitation of the oxygen transport [9][10][11][12]. In line with these reports, in the present study, we can show for the first time in a porcine animal model, that the traumainduced lung injury (depicted by increased LIS, Fig.…”

“…PMN migrate after their systemic activation by e.g. interleukin (IL)−8 into the pulmonary interstitium, release proteolytic enzymes and induce microvascular damage and harmful airway remodeling in lung tissue, which is associated with poor survival [9][10][11][12]. Moreover, the generation of inflammatory mediators including interleukin IL-8 plays an important role in ARDS pathophysiology [13][14][15][16].…”

Predictive value of cytokines for developing complications after polytrauma

“…IL-6: (1) ARDS; two studies [37,45] could not relate ARDS to IL-6 concentration alterations, whereas two other studies [48,51] found a positive correlation (Table 2); (2) Sepsis; five studies [35,41,46,47,53] found an increased IL-6 production to be predictive for the development of sepsis, whereas five other studies [28,29,38,39,55] did not (Table 3); (3) MODS; all five prospective cohort studies [3,28,34,46,51] concluded that IL-6 is markedly increased in the early development of MODS ( Dekker ABE et al . Do cytokines predict polytrauma outcome IL-10: (1) Three studies, two prospective [54,57] and one retrospective [14] , could not relate the serum IL-10 concentrations to the development of ARDS.…”

“…(1) Two prospective cohort studies [37,48] reported a positive correlation between increased serum IL-8 concentrations and development of ARDS, whereas one [45] found no predictive value; (2) Two studies [38,55] reported that IL-8 was not significantly different between patients developing sepsis and those with an uneventful posttraumatic course; (3) One cohort study [3] found a higher IL-8 serum concentration in patients with MODS, which could however not predict the development of multiorgan dysfunction; and (4) Of the six included studies, four prospective studies [27,32,36,56] concluded that IL-8 is significantly higher in MOF. Two prospective studies [11,42] also found a significantly increased serum concentration, but concluded that this could not be translated into a predictive value for adverse outcome.…”

“…Paunel-Görgülü et al [47] 2011 P-coh 47 (17) IL-6 38% 11% 34 Raymondos et al [48] 2012 P-coh 24 IL-6, -8, -1β, TNF- 29% 4% 35 Roetman et al [60] 2008 P-cc 229 (110) IL-18, -4; IFN-γ 16% 36 Schinkel et al [61] 2005 P-cc 216 (110) IL-11 4% 16% 37 Sherry et al [14] 1996 R-cc 66 (10) IL-10 8% 39% 2% 38 Sousa et al [51] 2015 P-coh 99 IL-6, -10; TNF- 19% 34% 28% 38 Spielmann et al [57] 2001 P-cc 47 (15) TNF- 11% 30% 51% 23% 39 Svoboda et al [62] 1994 P-cc 42 (12) IL-1β, -2, -6; TNF- 33% 26% 40 Wick et al [49] 2000 P-coh 37 IL-12 11% 16% 41 Yagmur et al [63] 2005 P-cc 99 (10) IL-1, -2, -6, -8; TNF- 17% Table 1 Overview of included studies, the studied cytokines and the outcome parameters (acute respiratory distress syndrome, sepsis, muli-organ dysfunction syndrome, multi-organ failure, mortality)…”