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1789 Bronchoalveolar Interleukin-1 Beta: A Marker of Bacterial Burden in Long Term Mechanical Ventilation Newborn with Ventilator-Associated Pneumonia
  1. D Dmytriiev,
  2. O Katilov,
  3. O Mazulov,
  4. K Dmytriieva
  1. Anesthesiology and Intensive Care, Vinnitsa National Medical University, Vinnitsa, Ukraine

Abstract

Objective To assess the relationship between concentrations of bronchoalveolar cytokines and bacterial burden (quantitative bacterial count) in long term mechanical ventilation newborn with a presumptive diagnosis of ventilator-associated pneumonia.

Interventions According to the time course of ventilator-associated pneumonia at the time of study with bronchoalveolar lavage, 44 newborn were divided into two subgroups: referral (n=18), and treated (n=26) ventilator-associated pneumonia. Bronchoalveolar lavage was performed in the most abnormal area on chest radiograph by fiberoptic bronchoscope. Bronchoalveolar lavage fluid was processed for quantitative bacterial culture. The concentrations of bronchoalveolar lavage cytokines (tumor necrosis factor-alpha, interleukin-1 beta, interleukin-6) also were measured.

Measurements and Main Results 26 patients had a positive bacterial culture (bronchoalveolar lavage > or = 10 colony-forming units/mL), and made up 79% of pathogens recovered at high concentrations. The concentrations of bronchoalveolar lavage interleukin-1 beta were 200.4 +/- 22.4 and 44.8 +/- 14.2 pg/mL (mean +/- se) in the newborn with positive and negative bacterial culture, respectively (p<0.001). Bronchoalveolar lavage interleukin- 1 beta was significantly higher in the newborn with a high bacterial burden (p<0.001), with mixed bacterial infection (p<0.001), and with ventilator-associated pneumonia (p<0.001), compared with values in patients without these features.

Conclusions Since the concentration of bronchoalveolar lavage interleukin-1 beta was correlated with bacterial burden in the alveoli, it may be a marker for progressive and ongoing inflammation in long term mechanical ventilation newborn.

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