Interleukin-8 is increased in cerebrospinal fluid of children with severe head injury

Objective: To determine interleukin (IL)-8 concentrations in ventricular ce rebrospinal fluid from children with severe traumatic brain injury (TBI), Design: Prospective study. Setting: University children's hospital. Patients: Twenty-seven children hospitalized with severe TBI (Glasgow Coma Scale score less than or equal to 8), seven children with cerebrospinal flu id culture-positive bacterial meningitis, and twenty-four age-equivalent co ntrols. Interventions: Placement of an intraventricular catheter and continuous dra inage of cerebrospinal fluid. Measurements and Main Results: Median [range] cerebrospinal fluid IL-8 conc entration in children with TBI (0-12 hrs) (4,452.5 [0-20,000] pg/mL) was ma rkedly greater than that in controls (14.5 [0-250]) (p <.0001) and equivale nt to concentrations in children with meningitis (5,300 [1,510-22,000] pg/m L) (p =.33), Cerebrospinal fluid IL-8 remained increased in children with s evere TBI for up to 108 hrs after injury, Univariate logistic regression an alysis demonstrated an association between cerebrospinal fluid IL-8 and chi ld abuse (p =.07) and mortality (p =.01), Multivariate analysis demonstrate d a strong, independent association between cerebrospinal fluid IL-8 and mo rtality (p =.01), Conclusions: The data are consistent with an acute inflammatory component o f TBI in children and suggest an association between cerebrospinal fluid IL -8 and outcome after TBI, IL-8 may represent a potential target for anti-in flammatory therapy.