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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Biomarkers, Body Fluids, Case-Control Studies, Chorioamnionitis, Female, Fetal Blood, Humans, Infant, Extremely Premature, Infant, Newborn, Inflammation Mediators, Interleukin-6, Male, Pregnancy, Respiration, Artificial, Trachea.
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Are increased levels of interleukin-6 in tracheal aspirate fluid indicative of fetal inflammation in ventilated extremely low gestational age newborns? Context: To determine whether increased serum and/or tracheal aspirate fluid (TAF) levels of IL-6 at birth are associated with fetal inflammation in ventilated extremely low gestational age newborns (ELGAN). A total of 36 ELGAN who required mechanical ventilation were enrolled in this study. The patients were classified into two groups: 19 infants who displayed histological evidence of funisitis, which is a marker of fetal inflammation, (funisitis group) and 17 infants without funisitis (comparison group). TAF samples were obtained during routine endotracheal suctioning performed within 2 hours of birth. The funisitis group exhibited significantly higher TAF IL-6 levels than the comparison group (2245 vs. 113 pg/mg total protein; p<0.001). The serum IL-6 levels of the funisitis group were also significantly elevated compared with those of the comparison group (median: 737 vs. 136 pg/mL, p=0.017). Receiver operating characteristic curve analysis of the association between IL-6 levels and the presence of funisitis revealed that the TAF IL-6 concentration had a higher area under the curve (0.947) than the serum IL-6 concentration (0.719). At a cut-off value of 216 pg/mg total protein, the TAF IL-6 level exhibited sensitivity and specificity values of 94.7% and 86.7%, respectively, for detecting funisitis.
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Elevated TAF IL-6 levels at birth are strongly associated with funisitis. The TAF IL-6 concentration is a useful marker for detecting fetal inflammation in ventilated ELGAN. Final Decision: yes