Limits of peritoneal cytokine measurements during abdominal lavage treatment for intraabdominal sepsis

Am J Surg. 2001 Apr;181(4):301-8. doi: 10.1016/s0002-9610(01)00587-6.

Abstract

Background: Monitoring of peritoneal cytokine concentrations of tumor necrosis factor (TNF)-alpha was recommended for early detection of severe postoperative complications. In the present study the clinical application of cytokine monitoring was examined in the treatment course of severe peritonitis.

Methods: Nineteen patients with secondary peritonitis were followed up during 75 abdominal lavages. Serum and peritoneal interleukin (IL)-6, IL-8, and IL-10 and TNF-alpha were measured before the surgical intervention, after 1 hour, 3 hours, 6 hours, and 24 hours. Additionally, cardiorespiratory parameters, osmolarity, C-reactive protein, and total leucocyte count were recorded.

Results: Serum and peritoneal cytokine concentrations did not correlate to each other as well as to the observed cardiorespiratory parameters. Peritoneal cytokine concentrations were 10- to 1000-fold higher to serum concentrations and showed an intermittent wash out. There were no differences in determined cytokine concentrations between survivors and nonsurvivors.

Conclusions: Once elevated, peritoneal cytokine measurements offer no new diagnostic or prognostic tool in abdominal lavage peritonitis treatment.

MeSH terms

  • Ascitic Fluid / chemistry*
  • Ascitic Fluid / cytology
  • Biomarkers / analysis
  • Blood Pressure
  • C-Reactive Protein / analysis
  • Cytokines / analysis*
  • Female
  • Humans
  • Interleukin-10 / analysis
  • Interleukin-6 / analysis
  • Interleukin-8 / analysis
  • Leukocyte Count
  • Male
  • Oxygen / blood
  • Peritoneal Lavage*
  • Peritonitis / diagnosis*
  • Peritonitis / etiology
  • Peritonitis / mortality
  • Peritonitis / physiopathology
  • Peritonitis / therapy
  • Postoperative Complications
  • Sepsis / diagnosis*
  • Sepsis / mortality
  • Sepsis / physiopathology
  • Sepsis / therapy
  • Survival Rate
  • Tumor Necrosis Factor-alpha / analysis
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Biomarkers
  • Cytokines
  • Interleukin-6
  • Interleukin-8
  • Tumor Necrosis Factor-alpha
  • Vasoconstrictor Agents
  • Interleukin-10
  • C-Reactive Protein
  • Oxygen