Muscular fatigue as one of the symptoms of organ dysfunction can contribute to difficult weaning from ventilatory support in septic patients on long-term ventilatory support. Pathogenesis of this muscular dysfunction is not completely understood; however, various experimental papers imply that TNF-a negatively affects diaphragm contractility and metabolism of striated muscles. In 40 patients we prospectively followed the levels of selected cytokines (TNF-a, IL-8, sIL-2R) during mechanical ventilation and weaning period. According to the length of weaning, patients were divided into two groups: group S, weaning period Ł 3 days, n = 15; group L, weaning period > 3 days, n = 22. Weaning period in patients from group S was 1,7 ± 0,7 days; in patients from group L 9,0 ± 3,7 days. Significantly higher and persistent levels of TNFa and IL-8 were found in group L. The results support the assumption that cytokines play a part in pathogenesis of muscular dysfunction in septic patients.

        Key words: sepsis – multiorgan dysfunction syndrome – muscular dysfunction – weaning from ventilator – cytokines