Limits of peritoneal cytokine measurements during abdominal lavage treatment for intraabdominal sepsis.
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.
Scheingraber
S
S
Department of General Surgery, Rheinische Friedrich-Wilhelms-University, Sigmund Freud Strasse 25, D-53105, Bonn, Germany. scheingraber@chir.uni-bonn.de
Bauerfeind
F
F
Böhme
J
J
Dralle
H
H
D001202:Ascitic Fluid / Q000737:chemistry* / Q000166:cytology; D015415:Biomarkers / Q000032:analysis; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis; D016207:Cytokines / Q000032:analysis*; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D007958:Leukocyte Count; D008297:Male; D010100:Oxygen / Q000097:blood; D010533:Peritoneal Lavage; D010538:Peritonitis / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D011183:Postoperative Complications; D018805:Sepsis / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D015996:Survival Rate; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D015415:Biomarkers; D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D014662:Vasoconstrictor Agents; D016753:Interleukin-10; D002097:C-Reactive Protein; D010100:Oxygen