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. 2015 Mar 23;10(3):e0120486.
doi: 10.1371/journal.pone.0120486. eCollection 2015.

Plasma cytokine levels fall in preterm newborn infants on nasal CPAP with early respiratory distress

Clarissa Gutierrez Carvalho  1 , Rita de Cassia Silveira  1 , Eurico Camargo Neto  1 , Renato Soibelmann Procianoy  1
Affiliations

Plasma cytokine levels fall in preterm newborn infants on nasal CPAP with early respiratory distress

Clarissa Gutierrez Carvalho et al. PLoS One. .

Abstract

Introduction: Early nCPAP seems to prevent ventilator-induced lung injury in humans, although the pathophysiological mechanisms underlying this beneficial effect have not been clarified yet.

Objective: To evaluate plasma levels IL-1β, IL-6, IL-8, IL-10, and TNF-α immediately before the start of nCPAP and 2 hours later in preterm infants.

Methods: Prospective cohort including preterm infants with 28 to 35 weeks gestational age with moderate respiratory distress requiring nCPAP. Extreme preemies, newborns with malformations, congenital infections, sepsis, surfactant treatment, and receiving ventilatory support in the delivery room were excluded. Blood samples were collected right before and 2 hours after the start of nCPAP.

Results: 23 preterm infants (birth weight 1851±403 grams; GA 32.3±1.7 weeks) were treated with nCPAP. IL-1β, IL-10, TNF-α levels were similar, IL-8 levels were reduced in 18/23 preterm infants and a significant decrease in IL-6 levels was observed after 2 hours of nCPAP. All newborns whose mothers received antenatal steroids had lower cytokine levels at the onset of nCPAP than those whose mothers didn't receive it; this effect was not sustained after 2 hours of nCPAP.

Conclusion: Early use nCPAP is not associated with rising of plasma pro-inflammatory cytokines and it seems to be a less harmful respiratory strategy for preterm with moderate respiratory distress.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Cytokine levels immediately after the onset of nCPAP and after 2 hours—Wilcoxon’s test.
Fig 2
Fig 2. Comparing cytokine levels regarding to antenatal steroid use immediately before the onset of nCPAP and after 2 hours, Mann-Whitney test.
See this image and copyright information in PMC

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