Correlations of cytokines, complement levels and acute phase reactants in preterm infants with respiratory disstress syndrome with disease severity, development of ventilator associated pneumonia and type of ventilation

Objective: To evaluate the correlations between levels of cytokines (IL-4, IL-8, IL-10, IL-13), complements (C3, C4) and acute phase reactants (CRP, procalcitonin) in tracheal aspirate samples with severity of RDS, type of ventilation and risk for development of ventilator associated pneumonia.Material-methods: Thirty eight infants at less than 32 weeks of gestation and birth weight lower 1500 gr with RDS were enrolled in the study. Tracheal aspirate samples were collected on 1, 3. and 7. days of life during mechanical ventilation. Twenty five patients received HFOV whereas 13 patients underwent CV. Ventilator associated pneumonia occured in 11 patients. Mechanical ventilation methods were compared in 27 patients without VİP.Results: IL-4 levels were statistically lower in VİP group compared to non-VİP group on the 7th day of life (p ? 0,05). On the other hand IL-4 levels showed similar courses in patients received HFOV and CV.There was no significant correlation betweeen VİP and non-VİP groups and also with mechanical ventilation methods (p ? 0,05).A significant increase in IL-10 levels on day 3 was observed in VİP group (p<0.05). There was no significant difference in IL-10 levels between HFOV and CV groups (p ? 0,05).There was no significant difference in IL-13 levels between VİP and non-VİP groups. But IL-13 levels on day 1 were significantly higher in HFOV groups compared to CV groups (p ? 0,05).No significant difference in procalcitonin levels was found between VİP and non-VİP groups and also mechanical ventilation modes (p ? 0,05).CRP measurements were similar in both patients and were detected at minimum detectable values.C3 and C4 levels were under detectable values.There was no significant correlation between OI and A-aDO2 indexes indicating severity of RDS with cytokines and acute phase reactants.Conclusion: IL-4, IL-8, IL-10, IL-13, C3, C4, CRP and PCT were not appropriate for determining the severity of RDS. IL-10 levels can be useful in the diagnosis of VİP. HFOV is not associated with a reduction of lung inflamation in comparison with CV in preterm infants with RDS.