Customize your JAMA Network experience by selecting one or more topics from the list below.
Puyo CA, Dahms TE. Innate Immunity Mediating Inflammation Secondary to Endotracheal Intubation. Arch Otolaryngol Head Neck Surg. 2012;138(9):854–858. doi:10.1001/archoto.2012.1746
Author Affiliations: Departments of Anesthesia and Critical Care, Washington University, St Louis, Missouri (Dr Puyo), and Saint Louis University, St Louis (Dr Dahms).
Objective To investigate the inflammatory markers associated with short-term endotracheal intubation in healthy surgical patients.
Design An observational and prospective study of subjects scheduled for same-day surgery procedures.
Setting Level I trauma center.
Patients Fourteen healthy patients intubated for same-day surgery procedures. The median duration of surgery was 3 hours.
Interventions Serial lavages above the tracheal cuff were obtained at the beginning of surgery, at 1 hour, and at the end of surgery; samples were assayed for cellular counts and levels of cytokines and complement 5a (C5a).
Results The total number of polymorphonuclear cells (PMNs) increased almost 10-fold from intubation to extubation (P < .01). The levels of 3 of the cytokines measured in tracheal lavage supernatants were significantly elevated over the time of intubation: tumor necrosis factor (TNF) (P < .01), interleukin 6 (IL-6) (P < .01), and IL-1β (P < .025). Levels of IL-8 showed an upward trend over time but were not significantly increased; C5a levels were significantly elevated over time (P < .05).
Conclusions Short-term intubation in healthy patients resulted in significant tracheal inflammation. Involvement of the innate immune system as documented in the present study provides information that may help to better understand the pathophysiologic characteristics of subglottic stenosis and other endotracheal injuries secondary to endotracheal intubation.
Create a personal account or sign in to: