Prevention by methylprednisolone of increased circulating tumor necrosis factor-alpha levels and lung injury associated with systemic inflammatory response syndrome due to intraperitoneal hyperthermia.
We previously demonstrated that intraperitoneal hyperthermic perfusion (IPHP), which is performed clinically as a treatment for patients with advanced gastrointestinal cancer, can lead to increased serum tumor necrosis factor-alpha (TNF-alpha), systemic inflammatory response syndrome (SIRS), and acute lung injury. Glucocorticoids inhibit the production and actions of TNF-alpha. We investigated whether pretreatment with methylprednisolone (MPS) may modulate serum TNF-alpha and lung injury in patients subjected to IPHP. Serum TNF-alpha was not detected in the patients pretreated with MPS, whereas serum TNF-alpha increased in the control patients (45.7 +/- 8.3 pg/mL, mean +/- SEM) after IPHP. Postoperative lung injury scores were significantly lower in patients pretreated with MPS than in the control patients (P < 0.001).


CONCLUSIONS
Pretreatment with methylprednisolone attenuates the increase in circulating tumor necrosis factor-alpha and prevents lung injury in this systemic inflammatory syndrome due to intraperitoneal hyperthermic perfusion.
Sumida
M
M
Department of Anesthesiology, Tokyo Women's Medical University Daini Hospital, Japan.
Inaba
H
H
Isawa
E
E
Fujimoto
S
S
Satoh
T
T
Kawamata
M
M
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D010529:Peritoneal Cavity; D011014:Pneumonia / Q000209:etiology / Q000517:prevention & control*; D011229:Preanesthetic Medication; D013274:Stomach Neoplasms / Q000097:blood / Q000628:therapy; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D000893:Anti-Inflammatory Agents; D014409:Tumor Necrosis Factor-alpha; D008775:Methylprednisolone