Systemic inflammatory response after bronchoalveolar lavage in critically ill patients

The European Respiratory Journal
T T BauerA Torres

Abstract

Bronchoscopic bronchoalveolar lavage (BAL) may be followed by a systemic inflammatory response. Previous reports have suggested pneumonia as a predisposing condition and systemic cytokines as possible mediators. To test this hypothesis, systemic levels of interleukin (IL)-1beta, IL-6 and tumour necrosis factor-alpha (TNF-alpha) were studied before and at 12 h and 24 h after bronchoscopically guided BAL in 30 mechanically ventilated patients (median age 67 (range 54-76) yrs, simplified acute physiology score II (SAPS II) 33 (12-56)), 20 of whom had pneumonia and 10 of whom were control patients without pneumonia. Arterial oxygen partial pressure to inspired oxygen fraction ratio (Pa,O2/FI,O2), body temperature, mean arterial pressure, and cardiac frequency were recorded. The majority of patients (28/30, 93%) received antibiotic treatment prior to the procedure. Pa,O2/FI,O2 ratio was lower at 12 h compared to baseline in patients with pneumonia (baseline median 192 (range 65-256); 12 h 160 (66-190) mmHg, p<0.001) and ventilated controls (baseline 293 (205-473); 12 h 226 (153-330) mm Hg p=0.011), but returned to baseline levels at 24 h (pneumonia: 194 (92-312), p=0.991; controls: 309 (173-487) mmHg, p=0.785). No changes in other c...Continue Reading

Citations

Jun 13, 2008·Critical Care : the Official Journal of the Critical Care Forum·Jorge I F SalluhPatrícia T Bozza
Sep 24, 2009·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Meng-Yi ChouChang-Wen Chen
Sep 10, 2008·Pediatric Pulmonology·Claire E WainwrightColin F Robertson
Dec 5, 2012·Journal of Bronchology & Interventional Pulmonology·Angel Estella, Antonio Jareño

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