Article Dans Une Revue Science Progress Année : 2025

Role of InterLeukin-6 monitoring during weaning from volume-controlled ventilation in patients with COVID-19 acute respiratory distress syndrome

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Objective The aim of this study was to assess the ability of plasma InterLeukin-6 (IL-6) monitoring to predict the failure to switch from volume-controlled ventilation to spontaneous ventilation (SV) in patients with COVID-19-related acute respiratory distress syndrome (ARDS).Methods: We conducted an observational, single-center and prospective cohort study in the medico-surgical intensive care unit of Avignon Hospital Center. Participants were adult patients requiring invasive mechanical ventilation for COVID-19-related ARDS between August 2021 and August 2022, who were eligible for switching from volume-controlled ventilation to SV. Results Among the 35 patients included in the study, 13 (37%) successfully switched from controlled ventilation to SV, while 22 failed (63%). In the failure group, mean plasma IL-6 levels were higher than in the successful group from hour 0 (defined as the moment of the switch to SV mode) to 48 h. However, differences between groups became significant from 24 h (362.8 vs. 33.6 pg/mL, P = 0.002). Interestingly, between-group differences in plasma C-reactive protein (CRP) levels were only significant between groups from 48 h (129.3 vs. 52.2 mg/L, P = 0.017). Finally, IL-6 and CRP had a similar ability to predict the failure to switch to SV mode: area under the receiving operative curves 0.763 [95%CI: 0.633-0.893] and 0.753 [95%CI: 0.595-0.911], respectively (P = 0.87).Conclusions: IL-6 and CRP are inflammatory biomarkers predictive of failure to switch to SV mode in COVID-19 ARDS patients. Our results showed that IL-6 can detect failure earlier than CRP. However, larger multicenter studies are needed to confirm our results, particularly in other ARDS models.

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hal-05038211 , version 1 (18-04-2025)

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Estelle Delaunay, Nicolas Poussard, Géraud Gourjon, Antoine Frouin, Pierre Ducq, et al.. Role of InterLeukin-6 monitoring during weaning from volume-controlled ventilation in patients with COVID-19 acute respiratory distress syndrome. Science Progress, 2025, 108 (2), ⟨10.1177/00368504251335850⟩. ⟨hal-05038211⟩
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