Local and Systemic Levels of IL-6 and IL-17 in Mechanically Ventilated Severe Pneumonia Patients

Abstract

Abstract Background: Pneumonia is a lung infection which is still a serious health problem worldwide. Intubation and mechanical ventilation are required in approximately 6% of patients that categorized as severe pneumonia. Furthermore, failed extubation was associated with increased mortality. The immunopathological process that occured in severe pneumonia is associated with increased levels of proinflammatory cytokines such as IL-6 and IL-17. Further study was need to evaluate the role of local and systemic immune processes through examination of cytokines levels in bronchoalveolar lavage fluid and blood and its correlation to adverse outcome of severe pneumonia. Objective: The aim of this study was to determine the differences of IL-6, IL-7 levels in bronchoalveolar lavage fluid and blood of severe pneumonia patients based on extubation and mortality status.Methods: This study was a prospective cohort in severe pneumonia patients who were intubated in Cipto Mangunkusumo Hospital from November 2020 to January 2021. Bivariate analysis using the Mann Whitney test was used on abnormally distributed data. Study subjects were observed for successful extubation of 20 days and mortality of 28 days.Results: In this study, the failed extubation rate was 80% and the mortality rate was 75%. There were no statistically significant difference between IL-6, IL-17 levels in bronchoalveolar lavage fluid and blood based on extubation status. There were also no statistically significant difference between IL-6, IL-17 levels in bronchoalveolar lavage fluid and blood based on mortality status. Conclusions: IL-6 and IL-17 levels in bronchoalveolar lavage and blood were not statistically different in the group of patients who failed to extubate and successfully extubated, and in those who deceased and those who lived.