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Original Paper

Cytokine Imbalance in Infants Receiving Extracorporeal Membrane Oxygenation for Respiratory Failure

Mildner R.J.a · Taub N.b · Vyas J.R.c · Killer H.M.a · Firmin R.K.a · Field D.J.c · Kotecha S.c

Author affiliations

aHeartlink ECMO Centre, Glenfield Hospital, Departments of bEpidemiology and Public Health, and cChild Health, University of Leicester, Leicester, UK

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Biol Neonate 2005;88:321–327

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: January 20, 2005
Accepted: June 05, 2005
Published online: November 15, 2005
Issue release date: November 2005

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 2

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

Abstract

Background: It is likely that the imbalance between the pro- and anti-inflammatory cytokines will determine the outcome in infants with severe respiratory failure receiving extracorporeal membrane oxygenation (ECMO). Aims: We determined if there was an imbalance between pro- and anti-inflammatory cytokines in serial bronchoalveolar lavage (BAL) fluid obtained from survivors and non-survivors of ECMO. Methods: We therefore measured the cellular changes and the molar ratios of pro-inflammatory and anti-inflammatory cytokines in serial BAL fluid obtained from survivors and non-survivors of ECMO. Fifteen infants surviving ECMO (median age 1 day, range 1–120) and 7 who did not (28 days, range 1–402) were studied. Results: In the lungs of survivors, the increased proportion of airway neutrophils at presentation decreased with time and was matched by a parallel increase in percent alveolar macrophages as the infants’ condition improved. The pro- and anti-inflammatory pulmonary cytokine ratios were static in the survivors. In the non-survivors, the ratio of tumour necrosis factor-α (TNF-α) against soluble TNF-receptor 1 (sTNF-R1) and soluble TNF receptor 2 (sTNF-R2) was increased at days 2–3 when compared to the survivors, but the molar ratio interleukin-1β (IL-1β)/soluble IL-1 receptor antagonist (sIL-1RA) was largely undetectable due to undetectable IL-1β. Conclusions: These data suggest that the infants who survive ECMO resolve their pulmonary inflammation and that in non-survivors the ratio of TNF-α against its receptor antagonists is increased and is associated with a poor outcome. Furthermore, this group of infants were unable to produce significant concentrations of IL-1β.

© 2005 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: January 20, 2005
Accepted: June 05, 2005
Published online: November 15, 2005
Issue release date: November 2005

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 2

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO


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