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The impact of interleukin serum levels on the prognosis of patients undergoing venoarterial extracorporeal membrane oxygenation.

OBJECTIVE
Extracorporeal life support is increasingly used in the treatment of patients presenting with cardiogenic shock or in need of cardiopulmonary resuscitation. Identifying therapeutic targets and factors associated with the prognosis are highly desirable. The present study analysed the impact of interleukins 6 and 8 on the outcome of patients undergoing VA ECMO.


METHODS
Interleukin 6 and 8 serum levels of 329 patients were analysed prior to, on day 1 and 5 of VA ECMO therapy. IL 6 and 8 serum levels of surviving and non-surviving patients were compared. At time points with significant differences, receiver operating characteristics and cut-off levels were analysed to determine the prognostic value of interleukin serum levels. Survival analysis was performed to compare patients above and below cut-off levels.


RESULTS
Interleukin 6 serum levels were significantly elevated in non-surviving patients prior to VA ECMO initiation. Interleukin 6 and 8 serum levels in non-surviving patients were significantly elevated on day 1 of VA ECMO. Receiver operating characteristics analysis revealed significant prognostic impact of interleukins 6 and 8 on day 1 of VA ECMO (AUC 0.70 and 0.72). Survival analysis comparing patients above and below cut-off showed a 1 year survival of 32.6% for IL6 and 20.8% for IL8 above, as well as 66.9% for IL6 and 61.9% for IL8 below the cut-off (p<0.05).


CONCLUSION
Interleukin 6 and 8 serum levels demonstrated prognostic value early in VA ECMO therapy. The technical applicability of interleukin reduction raises interest in interleukin 6 and 8 as therapeutic targets.