• Imo P Aisiku, Jose-Miguel Yamal, Pratik Doshi, Julia S Benoit, Shankar Gopinath, Jerry C Goodman, and Claudia S Robertson.
• Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. iaisiku@partners.org.
• Crit Care. 2016 Sep 15; 20: 288.

BackgroundPatients with severe traumatic brain injury (TBI) are at risk of the development of acute respiratory distress syndrome (ARDS). TBI and ARDS pathophysiologic mechanisms are known to independently involve significant inflammatory responses. The literature on the association between plasma inflammatory cytokines and ARDS in patients with TBI is sparse.MethodsThe study was a secondary analysis of the safety of a randomized trial of erythropoietin and transfusion threshold in patients with severe TBI. Inflammatory markers within the first 24 hours after injury were compared in patients who developed ARDS and patients without ARDS, using Cox proportional hazards models.ResultsThere were 200 patients enrolled in the study. The majority of plasma and cerebrospinal fluid (CSF) cytokine levels were obtained within 6 hours. Plasma proinflammatory markers IL-6 and IL-8 and anti-inflammatory marker IL-10 were associated with the development of ARDS (adjusted hazard ratio (HR) = 1.55, confidence interval (CI) = 1.14, 2.11, P = 0.005 for IL-6; adjusted HR = 1.32, CI = 1.10, 1.59, P = 0.003 for IL-8).ConclusionPlasma markers of IL-6, IL-8, and IL-10 are associated with ARDS in patients with severe TBI.Trial RegistrationNCT00313716 registered 4/2006.

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