Early measurement of IL-10 predicts the outcomes of patients with acute respiratory distress syndrome receiving extracorporeal membrane oxygenation

Liu, Chia Hsiung; Kuo, Shuenn‐Wen; Ko, Wen Je; Tsai, Pi Ru; Wu, Shu Wei; Lai, Chien Heng; Wang, Hsiu-Po; Chen, Yih‐Sharng; Chen, Pei Lung; Liu, Tze Tze; Huang, Sheng‐Jean; Jou, Tzuu-Shuh

doi:10.1038/s41598-017-01225-1

Cited by 28 publications

(25 citation statements)

References 49 publications

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“…We found significant increases in TNF-␣ and IL-10 after 120 min and significant increases in IL-6, -8, -12, and -1␤ after 180 min in all 7 animals who received LPS and developed ARDS, which is similar to cytokine profiles in other porcine models of ALI and ARDS (12). Importantly, the rapid and massive increases of TNF-␣, IL1-␤, IL-6, IL-8, and IL-10 that were observed in our model have been shown to be linked to mortality in ARDS patients (9). Interestingly, the PFR increased 60 -120 min before an increase in cytokines could be detected, indicating that online monitoring of particle flow may be a new, complementary approach in the clinic for early detection of ARDS.…”

Section: Discussionsupporting

confidence: 83%

Increased particle flow rate from airways precedes clinical signs of ARDS in a porcine model of LPS-induced acute lung injury

Stenlo

Hyllén

Silva

et al. 2020

American Journal of Physiology-Lung Cellular and Molecular Phys

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Lindstedt S. Increased particle flow rate from airways precedes clinical signs of ARDS in a porcine model of LPS-induced acute lung injury. Acute respiratory distress syndrome (ARDS) is a common cause of death in the intensive care unit, with mortality rates of~30 -40%. To reduce invasive diagnostics such as bronchoalveolar lavage and time-consuming in-hospital transports for imaging diagnostics, we hypothesized that particle flow rate (PFR) pattern from the airways could be an early detection method and contribute to improving diagnostics and optimizing personalized therapies. Porcine models were ventilated mechanically. Lipopolysaccharide (LPS) was administered endotracheally and in the pulmonary artery to induce ARDS. PFR was measured using a customized particles in exhaled air (PExA 2.0) device. In contrast to control animals undergoing mechanical ventilation and receiving saline administration, animals who received LPS developed ARDS according to clinical guidelines and histologic assessment. Plasma levels of TNF-␣ and IL-6 increased significantly compared with baseline after 120 and 180 min, respectively. On the other hand, the PFR significantly increased and peaked 60 min after LPS administration, i.e.,~30 min before any ARDS stage was observed with other well-established outcome measurements such as hypoxemia, increased inspiratory pressure, and lower tidal volumes or plasma cytokine levels. The present results imply that PFR could be used to detect early biomarkers or as a clinical indicator for the onset of ARDS.

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Section: Discussionsupporting

confidence: 83%

Increased particle flow rate from airways precedes clinical signs of ARDS in a porcine model of LPS-induced acute lung injury

Stenlo

Hyllén

Silva

et al. 2020

American Journal of Physiology-Lung Cellular and Molecular Phys

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“…During neonatal and adult ECMO, a dramatic fall of neutrophils and monocytes is consistently described. It can occur within 2 h of ECMO cannulation ( 13 , 14 , 22 ). In contrast to CPB where the number of leukocytes increased during open heart surgeries ( 40 , 43 ), leukocytopenia has long been reported in ECMO ( 16 , 25 ).…”

Section: Ecmo As a Second “Hit” To Leukocyte Pathophysiology In Critimentioning

confidence: 99%

Current Understanding of Leukocyte Phenotypic and Functional Modulation During Extracorporeal Membrane Oxygenation: A Narrative Review

Millar

Langguth

et al. 2021

Front. Immunol.

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A plethora of leukocyte modulations have been reported in critically ill patients. Critical illnesses such as acute respiratory distress syndrome and cardiogenic shock, which potentially require extracorporeal membrane oxygenation (ECMO) support, are associated with changes in leukocyte numbers, phenotype, and functions. The changes observed in these illnesses could be compounded by exposure of blood to the non-endothelialized surfaces and non-physiological conditions of ECMO. This can result in further leukocyte activation, increased platelet-leukocyte interplay, pro-inflammatory and pro-coagulant state, alongside features of immunosuppression. However, the effects of ECMO on leukocytes, in particular their phenotypic and functional signatures, remain largely overlooked, including whether these changes have attributable mortality and morbidity. The aim of our narrative review is to highlight the importance of studying leukocyte signatures to better understand the development of complications associated with ECMO. Increased knowledge and appreciation of their probable role in ECMO-related adverse events may assist in guiding the design and establishment of targeted preventative actions.

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“…Greater release of IL-10 after CPB was associated with improved cardiac index and pulmonary gas exchange [85] and increased chance of survival following cardiogenic shock in adults supported with ECMO [86]. Additionally, IL-10 levels in ARDS patients correlated with severity of illness and predicted unsuccessful ECMO weaning and mortality [87].…”

Section: Clinical Implications Of Ecls-associated Inflammatory Responsementioning

confidence: 99%

Extracorporeal life support and systemic inflammation

Al‐Fares

Pettenuzzo

Sorbo

2019

ICMx

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Extracorporeal life support (ECLS) encompasses a wide range of extracorporeal modalities that offer short- and intermediate-term mechanical support to the failing heart or lung. Apart from the daily use of cardiopulmonary bypass (CPB) in the operating room, there has been a resurgence of interest and utilization of veno-arterial and veno-venous extracorporeal membrane oxygenation (VA- and VV-ECMO, respectively) and extracorporeal carbon dioxide removal (ECCO 2 R) in recent years. This might be attributed to the advancement in technology, nonetheless the morbidity and mortality associated with the clinical application of this technology is still significant. The initiation of ECLS triggers a systemic inflammatory response, which involves the activation of the coagulation cascade, complement systems, endothelial cells, leukocytes, and platelets, thus potentially contributing to morbidity and mortality. This is due to the release of cytokines and other biomarkers of inflammation, which have been associated with multiorgan dysfunction. On the other hand, ECLS can be utilized as a therapy to halt the inflammatory response associated with critical illness and ICU therapeutic intervention, such as facilitating ultra-protective mechanical ventilation. In addition to addressing the impact on outcome of the relationship between inflammation and ECLS, two different but complementary pathophysiological perspectives will be developed in this review: ECLS as the cause of inflammation and ECLS as the treatment of inflammation. This framework may be useful in guiding the development of novel therapeutic strategies to improve the outcome of critical illness.

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Early measurement of IL-10 predicts the outcomes of patients with acute respiratory distress syndrome receiving extracorporeal membrane oxygenation

Cited by 28 publications

References 49 publications

Increased particle flow rate from airways precedes clinical signs of ARDS in a porcine model of LPS-induced acute lung injury

Increased particle flow rate from airways precedes clinical signs of ARDS in a porcine model of LPS-induced acute lung injury

Current Understanding of Leukocyte Phenotypic and Functional Modulation During Extracorporeal Membrane Oxygenation: A Narrative Review

Extracorporeal life support and systemic inflammation

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