Pulmonary levels of high-mobility group box 1 during mechanical ventilation and ventilator-associated pneumonia

Marieke A.D. van Zoelen, Akitoshi Ishizaka, Esther K. Wolthuls, Goda Choi, Tom van der Poll, Marcus J. Schultz

Research output: Contribution to journalArticleAcademicpeer-review

54 Citations (Scopus)

Abstract

High-mobility group box (HMGB) 1 is a recently discovered proinflammatory mediator that contributes to acute lung injury. We determined HMGB-1 levels in bronchoalveolar lavage fluid of patients during mechanical ventilation (MV) and ventilator-associated pneumonia (VAP). Bronchoalveolar lavage fluid was obtained from patients who were ventilated for 5 h because of an elective surgical procedure ("short-term MV"; n = 40) or for several days because of respiratory failure without acute lung injury ("long-term MV"; n = 10) and from patients who developed unilateral VAP (n = 4). Ten healthy volunteers served as controls. In healthy volunteers, HMGB-1 levels were low (median, 1.6 ngmL(-1); interquartile range [IQR], 0.7-3.7 ng mL(-1)). Although HMGB-1 levels were elevated after short-term MV, differences were not statistically significant compared with healthy volunteers (1.7 ng mL(-1); IQR, 0.8-8.5 ng mL(-1), P = 0.493 vs. healthy volunteers; P = 0.250 vs. start of MV). However, HMGB-1 levels were significantly higher in "long-term" MV patients (11.7 ng mL(-1); IQR, 8.7-37.0 ng mL(-1); P < 0.0001 vs. healthy volunteers). With unilateral VAP, HMGB-1 levels from the infected lung.were 17.4 (IQR, 8.5-23.2) ng mL(-1) (P = 0.014 vs. healthy controls); these levels were not different from those measured in the contralateral noninfected lung (P = 0.625). Summarized, long-term MV is associated with increased HMGB-1 levels in contrast to "short-term" MV. In addition, HMGB-1 levels during VAP are increased compared with healthy volunteers; however, they are not different from those found in patients intubated and mechanically ventilated for a similar period of time.

Original languageEnglish
Pages (from-to)441-445
Number of pages5
JournalShock
Volume29
Issue number4
DOIs
Publication statusPublished - Apr-2008
Externally publishedYes

Keywords

  • Adult
  • Aged
  • Bronchoalveolar Lavage Fluid
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • HMGB1 Protein
  • Humans
  • Lung
  • Male
  • Middle Aged
  • Pneumonia, Ventilator-Associated
  • Respiration, Artificial
  • Time Factors

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