Predictive value of interleukin 6 (IL-6), interleukin 8 (IL-8) and gastric intramucosal pH (pH-i) in major abdominal surgery.
OBJECTIVE
To study plasma concentrations of interleukin 6 (IL-6) and interleukin 8 (IL-8) in patients with splanchnic hypoxia, as documented by gastric intramucosal measurements (pH-i), during major abdominal surgery and the relationship between IL-6 and IL-8 concentrations and postoperative complications as well as clinical outcome.


METHODS
A prospective study.


METHODS
Twelve patients scheduled for major abdominal surgery with no evidence of coexisting infectious disease.


RESULTS
Six out of seven samples from patients with postoperative complications showed intraoperative pH-i levels lower than 7.32 and IL-6 levels higher than 300 pg/ml. Seven out of nine samples from patients without complications showed pH-i levels higher than 7.32 and IL-6 levels lower than 300 pg/ml. The difference in the pattern of distribution was statistically significant (p < 0.01). Only two out of seven samples of patients with postoperative complications showed intraoperative pH-i levels lower than 7.32 and IL-8 levels higher than 60 pg/ml. It was not possible to identify a clear distribution pattern of data points for IL-6 and IL-8 during the postoperative period.


CONCLUSIONS
Intraoperative splanchnic ischemia, as documented by gastric intramucosal pH-i, is directly correlated to the increase of IL-6 plasma levels and to the incidence of postoperative complications, while IL-8 levels showed no correlation with surgical complications.
Donati
A
A
Department of Medical and Surgical Emergencies, University of Ancona, Ospedale Regionale Torrette, Italy. donati@indi.it
Battisti
D
D
Recchioni
A
A
Paoletti
P
P
Conti
G
G
Caporelli
S
S
Adrario
E
E
Pelaia
P
P
Pietropaoli
P
P
D000328:Adult; D000368:Aged; D015687:Cell Hypoxia / Q000276:immunology*; D005753:Gastric Mucosa / Q000098:blood supply*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D015994:Incidence; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D007431:Intraoperative Complications / Q000097:blood / Q000209:etiology / Q000276:immunology*; D007511:Ischemia / Q000097:blood / Q000209:etiology / Q000276:immunology*; D007813:Laparotomy / Q000009:adverse effects*; D016014:Linear Models; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013152:Splanchnic Circulation; D016896:Treatment Outcome
D015850:Interleukin-6; D016209:Interleukin-8