title: The influence of surgery on cytokines in patients with intra-abdominal sepsis.
abstract: The cytokine cascade which is triggered by severe sepsis may contribute to progressive organ dysfunction and death from sepsis. This cascade may be accentuated by surgery for sepsis and pre-treatment with cytokine blockers could possibly ameliorate the response. This prospective controlled study determined the effect of surgery in 11 haemodynamically stable patients undergoing laparotomy for intra-abdominal sepsis. Serum levels of endotoxin, IL-1, IL-6, IL-8 and TNF-alpha were determined; blood cultures, features of systemic inflammatory response, and organ dysfunction were monitored over the peri-operative period. There was considerable variation in the serum cytokine levels. The preoperative IL-6 levels were significantly elevated in the septic patients and a threefold increase in IL-6 levels occurred in both groups postoperatively. An increase in TNF-alpha did not achieve significance because of high levels in control patients with cancer. Cytokine release which occurs during abdominal surgery is increased in patients with intra-abdominal sepsis.
authors.affiliation: Department of Anaesthesia, University of Cape Town, South Africa.
authors.forename: J M
authors.initials: JM
authors.lastname: Hammond
authors.forename: P D
authors.initials: PD
authors.lastname: Potgieter
mesh_terms: D018784:Abdominal Abscess / Q000097:blood* / Q000601:surgery*; D016022:Case-Control Studies; D003422:Critical Care; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D016207:Cytokines