Interleukin-18 levels reflect the long-term prognosis of acute lung injury and acute respiratory distress syndrome
Journal of Anesthesia,  Clinical Article

Makabe H et al. – The present data demonstrate an inverse correlation between serum interleukin (IL)–18 level and the P/F ratio, suggesting the possible involvement of IL–18 in the pathogenesis of respiratory failure in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). Early–stage serum IL–18, IL–12, and tumor necrosis factor (TNF)–α levels appear to reflect the >60–day prognosis in patients with ALI/ARDS.

Methods
  • The study subjects were 38 patients with acute respiratory failure treated at the institution during the 4-year period from April 2004 to March 2008.
  • The underlying clinical condition was defined as acute respiratory distress syndrome (ARDS; n=12) or acute lung injury (ALI; n=26).
  • The serum levels of interleukin (IL)-18, IL-12, and tumor necrosis factor (TNF)-α were measured by enzyme-linked immunosorbent assays.

Results
  • The ARDS group showed significantly higher serum levels of IL-18, IL-12, and TNF-α even at an early stage after disease onset compared with the ALI group.
  • A negative correlation was noted between the PaO2/FIO2 ratio (P/F ratio) and serum IL-18 level.
  • Analysis of all 38 patients with ALI/ARDS revealed a 30-day mortality rate of 7.9 %, 60-day mortality rate of 15.8 %, and 90-day mortality rate of 18.4 %.
  • The early-stage serum levels of IL-18, IL-12, and TNF-α were significantly higher in the non-survivors at 60 and 90days, but not at 30days, than in the corresponding survivors.

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